Impact of Early Operation on the Mortality from Bleeding Peptic Ulcer

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Abstract
A prospective trial, including 88 patients with bleeding peptic ulcer consecutively admitted to our hospital between Januray 1982 and September 1983, was conducted in order to determine how far the initial decision of operative versus medical therapy can benefit from emergency endoscopic findings. The dominating criteria for choice of treatment were bleeding type and bleeding activity according to the modified Forrest classification. The overall mortality was 4.5 % (4 % for duodenal ulcer, 5 % for gastric ulcer). 35 patients underwent surgery with only two hospital deaths (6%). Among the group with conservative treatment there were two additional deaths (4%), all patients being above 60 years of age with serious risk factors. Early results of our newly designed strategy seem to suggest that mortality rates in patients with bleeding gastroduodenal ulcers can be reduced considerably by a more aggressive surgical approach.

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