Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study
Abstract Aim Although perforated peptic ulcer is common in Japan, few large‐scale studies have assessed its management, including surgical procedures and outcomes. This study aimed to survey the characteristics, management, and outcomes of perforated peptic ulcer. Methods A multicenter retrospective...
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Wiley
2025-05-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.12908 |
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| author | Hiromasa Hoshi Akira Endo Koji Ito Tomohiro Akutsu Hikaru Odera Hideto Shiraki Kei Ito Takeshi Yokoyama Yasukazu Narita Taro Masuda Akira Suekane Koji Morishita |
| author_facet | Hiromasa Hoshi Akira Endo Koji Ito Tomohiro Akutsu Hikaru Odera Hideto Shiraki Kei Ito Takeshi Yokoyama Yasukazu Narita Taro Masuda Akira Suekane Koji Morishita |
| author_sort | Hiromasa Hoshi |
| collection | DOAJ |
| description | Abstract Aim Although perforated peptic ulcer is common in Japan, few large‐scale studies have assessed its management, including surgical procedures and outcomes. This study aimed to survey the characteristics, management, and outcomes of perforated peptic ulcer. Methods A multicenter retrospective descriptive analysis was conducted across seven centers in Japan between 2011 and 2022. Perforated peptic ulcer was defined as gastric or duodenal ulcer perforation, excluding malignant or iatrogenic perforation. Results We enrolled 703 patients with perforated peptic ulcer. The overall in‐hospital mortality rate was 35/703 (5.0%). Conservative treatment was performed as an initial treatment in 217/703 (30.9%) patients, among whom 52 (24.0%) eventually underwent surgery. The median age (interquartile range) of patients who successfully completed the conservative treatment was 60 (46–71) years. A total of 538/703 (76.5%) patients underwent surgery. The gastrectomy percentage increased with the perforation diameter. The anastomotic leakage rate for gastrectomy was high in 10/66 (15.2%) patients. Laparoscopy was performed in 115/538 (21.4%) patients, among whom 23 (20.0%) were converted to open surgery. Patients who underwent laparoscopy had a perforation diameter ≤ 20 mm. The use of laparoscopy varied among facilities, ranging from 1.8% to 61.2%. Conclusion The in‐hospital mortality rate for perforated peptic ulcer in this study was 5.0%, and conservative treatment was safely performed even in elderly patients. As the perforation diameter increased, the rate of gastrectomy tended to rise, and the rate of anastomotic leakage in those patients was high. UMIN Clinical Trials Registry; UMIN000054391. |
| format | Article |
| id | doaj-art-e5a3ebc3e86f4591b3c83aa01ce9a46c |
| institution | OA Journals |
| issn | 2475-0328 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-e5a3ebc3e86f4591b3c83aa01ce9a46c2025-08-20T02:30:54ZengWileyAnnals of Gastroenterological Surgery2475-03282025-05-019346447510.1002/ags3.12908Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive studyHiromasa Hoshi0Akira Endo1Koji Ito2Tomohiro Akutsu3Hikaru Odera4Hideto Shiraki5Kei Ito6Takeshi Yokoyama7Yasukazu Narita8Taro Masuda9Akira Suekane10Koji Morishita11Department of Acute Critical Care Medicine Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Acute Critical Care Medicine Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Gastroenterological Surgery Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Acute Critical Care Medicine Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Acute Critical Care and Disaster Medicine Tokyo Medical and Dental University Graduate School of Medicine and Dental Sciences Tokyo JapanDepartment of Surgery Chiba Rosai Hospital Chiba JapanDepartment of Surgery Fujisawa City Hospital Fujisawa Kanagawa JapanDepartment of Surgery Ohtanishinouchi General Hospital Fukushima JapanDepartment of Surgery National Hospital Organization Mito Medical Center Ibaraki JapanDepartment of Emergency and Critical Care Center Matsudo City General Hospital Chiba JapanDepartment of Acute Critical Care and Disaster Medicine Tokyo Medical and Dental University Graduate School of Medicine and Dental Sciences Tokyo JapanDepartment of Acute Critical Care and Disaster Medicine Tokyo Medical and Dental University Graduate School of Medicine and Dental Sciences Tokyo JapanAbstract Aim Although perforated peptic ulcer is common in Japan, few large‐scale studies have assessed its management, including surgical procedures and outcomes. This study aimed to survey the characteristics, management, and outcomes of perforated peptic ulcer. Methods A multicenter retrospective descriptive analysis was conducted across seven centers in Japan between 2011 and 2022. Perforated peptic ulcer was defined as gastric or duodenal ulcer perforation, excluding malignant or iatrogenic perforation. Results We enrolled 703 patients with perforated peptic ulcer. The overall in‐hospital mortality rate was 35/703 (5.0%). Conservative treatment was performed as an initial treatment in 217/703 (30.9%) patients, among whom 52 (24.0%) eventually underwent surgery. The median age (interquartile range) of patients who successfully completed the conservative treatment was 60 (46–71) years. A total of 538/703 (76.5%) patients underwent surgery. The gastrectomy percentage increased with the perforation diameter. The anastomotic leakage rate for gastrectomy was high in 10/66 (15.2%) patients. Laparoscopy was performed in 115/538 (21.4%) patients, among whom 23 (20.0%) were converted to open surgery. Patients who underwent laparoscopy had a perforation diameter ≤ 20 mm. The use of laparoscopy varied among facilities, ranging from 1.8% to 61.2%. Conclusion The in‐hospital mortality rate for perforated peptic ulcer in this study was 5.0%, and conservative treatment was safely performed even in elderly patients. As the perforation diameter increased, the rate of gastrectomy tended to rise, and the rate of anastomotic leakage in those patients was high. UMIN Clinical Trials Registry; UMIN000054391.https://doi.org/10.1002/ags3.12908duodenal perforationduodenal ulcergastric perforationgastric ulcerperforated peptic ulcer |
| spellingShingle | Hiromasa Hoshi Akira Endo Koji Ito Tomohiro Akutsu Hikaru Odera Hideto Shiraki Kei Ito Takeshi Yokoyama Yasukazu Narita Taro Masuda Akira Suekane Koji Morishita Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study Annals of Gastroenterological Surgery duodenal perforation duodenal ulcer gastric perforation gastric ulcer perforated peptic ulcer |
| title | Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study |
| title_full | Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study |
| title_fullStr | Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study |
| title_full_unstemmed | Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study |
| title_short | Analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022: A multicenter and retrospective descriptive study |
| title_sort | analysis of the characteristics and management of perforated peptic ulcer from 2011 to 2022 a multicenter and retrospective descriptive study |
| topic | duodenal perforation duodenal ulcer gastric perforation gastric ulcer perforated peptic ulcer |
| url | https://doi.org/10.1002/ags3.12908 |
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