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REVIEW ARTICLE
Year : 2017  |  Volume : 23  |  Issue : 1  |  Page : 1-4

Surgical scales: Primary closure versus gastric resection for perforated gastric ulcer - A surgical debate


1 Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
2 Department of ICU and Anaesthesiology, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia

Correspondence Address:
Mahir Gachabayov
Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, 600022, Stavrovskaya Street, 6-73, Vladimir
Russia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1117-6806.199959

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Perforated gastric ulcer is one of the most life-threatening complications of peptic ulcer disease with high morbidity and mortality rates. The surgical strategy for gastric perforation in contrast with duodenal perforations often requires consilium and intraoperative debates. The subject of the debate is a 59-year-old male patient who presented with perforated giant gastric ulcer complicated by generalized peritonitis and severe sepsis. The debate is based on a systematized table dividing all factors into three groups and putting them on surgical scales. Pathology-related factors influencing the decision-making are size and site of perforation, local tissue inflammation, signs of malignancy, simultaneous complications of peptic ulcer, peritonitis, and sepsis. Besides these factors, patient- and healthcare-related factors should also be considered.


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