Gastric body partition for giant perforated peptic ulcer in critically ill elderly patients.

Abstract

To prevent or minimize leakage after simple closure of giant perforated peptic ulcers in critically ill elderly patients, we conducted a clinical study using gastric body partition to prevent upstream gastric juice and food from passing through the sutured ulcer. Ten critically ill elderly patients with giant (> 2.5 m) perforated peptic ulcer were included in the study of gastric body partition. The patients' mean age was 78.2 years and mean delay in treatment was 95.6 hours. None of the 10 patients had major complications after operation, although minor leakage of the sutured ulcer occurred in 4 patients. Only one patient presented with recurrent anastomotic ulcer and one patient died 28 days after surgery. Gastric body partition and gastrojejunostomy, in addition to simple closure of a giant perforated peptic ulcer, could be a quick, easy, and potentially effective alternative to avoid or at least to minimize leakage of the sutured ulcer. Moreover, gastric body partition, unlike antral partition, might not necessarily increase risks of hypergastrinemia and marginal ulcer.