KẾT QUẢ SỚM CỦA ĐIỀU TRỊ NGOẠI KHOA THỦNG LỚN Ổ LOÉT DẠ DÀY TÁ TRÀNG

Abstract

Background: Surgical management of giant peptic ulcer perforations remains a significant challenge for surgeons, associated with high morbidity and mortality rates. This study aims to evaluate the early postoperative outcomes of surgical treatment for giant gastroduodenal ulcer perforations. Method: This retrospective case series analyzed patients with giant perforated peptic ulcers and a perforation diameter ≥ 2 cm treated at Gia Dinh People’s Hospital between June 2021 and March 2024. Results: During the study period, 44 patients with giant peptic ulcer perforations were included in study. Surgical management included primary closure (n = 34), gastrectomy (n = 7), and the Newman procedure (n = 3). The median age was 70 years (range: 23–94 years), with a male-to-female ratio of 1.3:1. Patients with ASA physical status III and IV accounted for 88.7% of the cases. Preoperative septic shock was present in 34.1% of the patients. The overall morbidity rate was 75%, with subgroup rates of 70.4% for primary closure, 71.4% for gastrectomy, and 100% for the Newman procedure. The overall mortality rate was 50%; specifically, 44.1% in the primary closure group, 71.4% in the gastrectomy group, and 66.7% in the Newman procedure group. Conclusion: Patients with giant peptic ulcer perforations frequently present with a severe clinical status. Primary closure remains the most commonly utilized surgical approach. The incidence of postoperative complications and motalities remains high in this study.