• acute care surgery
• gastrointestinal
• general surgery
• peptic ulcer disease
• vagotomy

• duodenal perforation
• duodenal ulcer
• gastric perforation
• gastric ulcer
• perforated peptic ulcer

Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed. It is often the result of chronic peptic ulcer disease, which is characterized by a breach in the gastric wall due to ulceration. Surgical intervention is essential for managing this life-threatening complication. However, the optimal surgical technique remains debatable among clinicians. Various methods have been employed, including simple closure, omental patch repair, and partial gastrectomy, each with distinct advantages and disadvantages. Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making. This study addresses the need for a comprehensive analysis in this area.

To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.

A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023. The patients were divided into three groups based on the surgical method: Simple closure, omental patch repair, and partial gastrectomy. The primary outcomes were the operative success rate and incidence of postoperative complications. Secondary outcomes included the length of hospital stay, recovery time, and long-term quality of life.

The operative success rates for simple closure, omental patch repair, and partial gastrectomy were 92.5%, 95%, and 97.5%, respectively. Postoperative complications occurred in 20%, 15%, and 17.5% of patients in each group, respectively. The partial gastrectomy group showed a significantly longer operative time (P < 0.001) but the lowest rate of ulcer recurrence (2.5%, P < 0.05). The omental patch repair group demonstrated the shortest hospital stay (mean 7.2 days, P < 0.05) and fastest recovery time.

While all three surgical methods showed high success rates, omental patch repair demonstrated the best overall outcomes, with a balance of high efficacy, low complication rates, and shorter recovery time. However, the choice of the surgical method should be tailored to individual patient factors and the surgeon’s expertise.

• Gastric ulcer perforation
• Surgical methods
• Simple closure
• Omental patch repair
• Partial gastrectomy
• Postoperative complications

• Duodenal ulcer
• Gastric ulcer
• Gastrointestinal perforations
• Omental patch repair
• Perforated ulcer

• giant
• peptic ulcer
• perforation
• stomach

• Efficacy
• Etress response
• Pantoprazole
• Peptic ulcer
• Perforation repair

• Global Burden of Disease
• age-standardized DALYs rates
• age-standardized incidence rates
• age-standardized mortality rates
• inequalities
• peptic ulcer disease

Introduction  Peptic ulcer disease continues to be a major public health in most developing countries despite the advances in medical management. The incidence of perforations remains high and has the highest mortality rate of any complication of ulcer disease. Risk stratification of cases will lead to better preoperative management and efficient utilization of intensive care unit resources. The purpose of the present study is to compare different existing scoring systems and identify the most accurate predictor of mortality in perforated peptic ulcer (PPU) cases.

Materials and Methods  This is an observational study conducted in Karnataka Institute of Medical Sciences, Hubli, India. All cases of PPU disease admitted from December 2017 to August 2019 who were treated surgically were included in the study. Demographic data were collected and peptic ulcer perforation (PULP) score, Mannheim peritonitis index (MPI), American Society of Anesthesiologists (ASA) score, and Jabalpur score (JS) were calculated for individual patient and compared. The patient was followed up during the postoperative period.

Observation  A total of 45 patients were included in the study with a mean age of 42.5 years. Most of the patients presented with 24 hours of the onset of symptoms. Nonsteroidal anti-inflammatory drug use was noted in 8.9% patients, and steroid use was present in 2.2% patients. Of the 45 patients, 7 deaths were reported. Between the various scoring systems, the MPI and JS were better predictors of mortality with a p -value of <0.001 and 0.007, respectively. In contrast, the PULP and ASA scores had p -value not statistically significant. However, the PULP score was a better predictor of postoperative complication with a p -value of 0.047.

Conclusion  Of the four scoring systems validated, the MPI and JS were better predictors of mortality in the given population. PULP score is a better predictor of postoperative complications in the present study.

• gastrectomy
• omental patch
• peptic ulcer
• perforated ulcer
• ulcer size

• Appendicitis
• Diverticular disease of appendix