Variations reported in surgical practice for bleeding duodenal ulcers

Reuben, Brian C.; Neumayer, Leigh A.

doi:10.1016/j.amjsurg.2006.08.021

« Previous Next »The American Journal of Surgery
Volume 192, Issue 5 , Pages e42-e45, November 2006

Variations reported in surgical practice for bleeding duodenal ulcers

Presented at the 30th Annual Surgical Symposium of the Association of VA Surgeons, Cincinnati, Ohio, May 7–9, 2006

Division of General Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA

Received 15 May 2006; received in revised form 3 August 2006

Abstract

Background

To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed.

Methods

FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had recertified in general surgery (RECERT) were compared with young FAC who had not and RES (RES/young FAC). Two-group comparisons were performed.

Results

Seventy-three percent of FAC and 62% of RES responded. RES perform more ARPs on hemodynamic (HD), unstable, elderly patients than FAC (P = .013). On the elderly patient, RES/young FAC perform more ARPs in a HD stable (P = .07) and unstable condition (P = .18). HD unstable patients would undergo OS more frequently than stable patients (P = .016).

Conclusions

In this survey, the choice of optimal surgical procedure for an acute bleeding ulcer varies among surgeons based on years of surgical experience and individual patient factors.

Keywords: Duodenal ulcer, Peptic ulcer, Vagotomy, Survey, Practice patterns