Abstract

During the last twenty years we have witnessed a revolutionary change in treatment and diagnosis of peptic ulcer disease (PUD). It was introduction of flexible fiberoptic instruments and new drugs: H-2 blockers, proton pump inhibitors (PPI) and treatment against Helicobacter pylori which affected most significantly the course of this illness. Although indications for surgical intervention have not been changed, practice of surgery in this regard has changed a lot. In this report two periods of time were analyzed and compared: years 1977-81 and 1992-96. Operation reports from the above defined periods were reviewed and all surgeries performed for PUD and its complications have been noted along with data regarding patients and indications for surgery as reported by operating surgeons. There were 360 surgeries for PUD performed in the 1977-1981 period, and 246 in the years 1992-1996. Patients were divided into groups depending on indications for surgery. A significant reduction in the general number of operations performed was noted. The percentage of women operated upon increased. The mean age of patients in all indication groups was higher in the latter period. Patients operated for bleeding tended to be older than those in perforation and intractable disease groups. This was true in both periods of time. The number and percentage of patients operated for perforation increased. The natural course of PUD is changing; intractable disease as an indication for surgery is disappearing, the number of pyloric obstruction patients is diminishing, the incidence of bleeding and perforation remains constant. The mean age of patients and percentage of women is increasing.
key words: peptic ulcer disease • complication rate • indication for surgery

Keywords: indication for surgery, complication rate, peptic ulcer disease