Clinical Study and Factors Influencing Postoperative Morbidity in Perforated Peptic Ulcer Patients

ABSTRACT

PURPOSE: After the introduction of peptic ulcer medication, a marked decrease took place in the number of patients with uncomplicated peptic ulcers subjected to elective surgery. This decline, however, was not associated with a decrease in the number of patients admitted with peptic ulcer perforation. Also, the morbidity and mortality were increased because the perforated peptic ulcers mostly occurred in elderly patients with medical illnesses. The purpose of this study was to evaluate the postoperative morbidity in patients with a perforated peptic ulcer. METHODS: Between January 2000 and December 2005, 110 consecutive patients, who underwent surgery for perforated peptic ulcer at Seoul Red Cross Hospital department of general surgery, were retrospectively reviewed. RESULTS: The overall morbidity and the mortality rates were 23.6 and 5.45%, respectively. The most common postoperative complication was postoperative ileus, followed by wound infections and pulmonary complications. The most common cause of death was sepsis. A univariate analysis showed sex, age, a delayed operation, site and size of perforation, the size of crater, comorbid diseases, and type and duration of operation were associated factors; however, the multivariate analysis showed age, a delayed operation, size of perforation, comorbid diseases, and type and duration of operation were independent risk factors. CONCLUSION: Age, a delayed operation, size of perforation, comorbid diseases, and type and duration of operation were independent risk factors for a perforated peptic ulcer. Therefore, to decrease the postoperative morbidity, comorbid diseases must be treated during the perioperative period, perforated peptic ulcer must be correctly diagnosed immediately and short time consuming operative procedures must be performed.