To analyze the clinical aspect and long-term effect of surgical treatment of peptic ulcer, we reviewed 135 patients treated during Jan. 1985 to Dec. 1991 at Department of Surgery, Chun Cheon Sacred heart Hospital.
The ratio of duodenal ulcer to gastric ulcer was 1.4: 1. The age of peak incidence were 6 th decade in gastric ulcer and 3 rd decade in duodenal ulcer. In monthly distribution, peak incidence of gastric ulcer showed at October(17.9%), And peak
incidence
of duodenal ulcer showed at September(17%). The durations of symptom were mainly 1-3 years at perforation, 6~12 months at bleeding, and 5 years at obstruction. Approximately 83% of patient at perforation demonstrated free air under diaphragm on
upright
chest film. The complication was directly preoperative to preoperative length of stay(p<0.01, CI=99%). The locations of perforation were duodenum(65%), pylorus(15.6%), antrum(10.9%), body(7.8%) in order of frequency. A high percentage(46.1%) of
duodenal
ulcer patients presented with a type O blood grouping, and gastric ulcer with a type A blood grouping. As to operative procedure, truncal vagotomy with pyloplasty was performed in 40.0% subtotal gastrectomy in 25.2%, truncal vagotomy with
antrectomy in
20.7%, primary closure in 7.4% truncal vagotomy with gastrojejunostomy in 5.2%, and highly selective vagotmy in 1.5%. Postoperative complications developed in 23.7%, and postoperative mortality in 5.2%. The late complication were classified
according to
the modified Visick classification. In this study, truncal vagotomy with antrectomy in gastric ulcer was considered to have good result, and truncal vagotomy with antrectomy and subtotal gastrectomy in duuodenal ulcer was considered to have good
result.
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