Yee, Gan Yiing (2022) A retrospective study on surgical approach and outcome in giant perforated peptic ulcer disease. Masters thesis, Universiti Sains Malaysia.
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Abstract
Introduction: Perforated peptic ulcer (PPU) carries high risk for morbidity and mortality,The mainstay treatment is surgery which includes either primary repair or gastric resection. Objective: To evaluate the factors affecting outcomes from different surgical approaches in giant PPU. Methods: A retrospective review of all patients with PPU who underwent surgery from January 2016 to December 2020 was done. Patients with PPU less than 2cm were excluded. Patient demographics and perioperative data were recorded. Length of stay, post-operative complications , need for ICU admission and all-cause mortality are reported. Results: Fifty-four patients with a median age of 60 (range 15–83) years old had PPU ≥2 cm. Eighteen (33.3%) patients presented within 24 hours from the onset of abdominal pain. The median American Society of Anaesthesiology score was 3 (range 1–4). Twenty-four patients had primary repair and 30 patients had gastrectomy. The overall incidence of anastomotic leak,intraabdominal collection, re-operation and 30 days mortality was 18.5%, 25.9%, 9.3% and 27.8%, respectively. No difference in post-operative outcomes between the two groups was detected: intra-abdominal collection (p=0.172), post-operative leakage (p=0.754), re-operation (p=0.834) and all-cause mortality (p=0.736). Conclusions: Giant PPU can be managed by either primary repair or gastrectomy, perioperative outcomes between two groups are comparable hence a careful selection of surgical approach should be made with consideration of perioperative factors to reduce post-operative morbidity and mortality
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | perforated peptic ulcer, gastrectomy |
| Subjects: | R Medicine R Medicine > RD Surgery |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 20 Apr 2026 23:37 |
| Last Modified: | 14 Jun 2026 02:38 |
| URI: | http://eprints.usm.my/id/eprint/63941 |
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