To determine the changing trend in surgical aspect of peptic ulcer, we reviewed 1,275 patients treated during 1968 to 1989 at Department of Surgery, Seoul National University Hospital. The incidence of gastric ulcer has gradually increased
whereas
that
of duodenal ulcer has decreased. The intractability as an indication of peptic ulcer surgery has decreased. Subtotal gastrectomy has decreased whereas truncal vagotomy with antrectomy and selective vagotomy with antrectomy have increased in
duodenal
ulcer. Early postoperative complications and operative mortality have decreased. Nine hundred and ninety patients with peptic ulcer treated during 1980 to 1989 were analized. The indications for surgery were perforation(73.3%),
obstruction(17.3%),
hemorrhage(6.2%), hemorrhage(18.2%), obstruction(10.4%), and intrac-tability(4.9%) in gastric ulcer. Postoperative complication and mortality in perforation and hemorrhage are significantly high. As a results of univariate study, age, blood
pressure,
pulse rate at arrival, and preoperative transfusion requirement are significant factors affecting mortality in patients operated upon for hemorrhage of peptic ulcer disease. The late complications were classified according to the modified Visick
classification. In this study the selective vagotomy with antrectomy was the most commonly performed procedure. However, the worldwide trend of common surgery for peptic ulcer is highly selective vagotomy. Therefore we should perform more highly
selective vagotomy in the future.
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