Analysis of risk factors for postoperative complications in assessing the results of surgical treatment of patients with perforated ulcer

Abstract

Emergency operations for perforated gastroduodenal ulcers are associated with a high incidence of postoperative complications.  A number of studies have examined the impact of perioperative risk factors and comorbidities on postoperative morbidity after abdominal surgery, but only a few have looked at their role in perforated peptic ulcer disease.Aim. To determine possible associations between postoperative complications, comorbidity and perioperative risk factors for perforated gastroduodenal ulcer.Materials and methods. This study includes the anamnesis of 142 patients who underwent surgery for perforated gastroduodenal ulcer (PGD). In 74 cases (52.1 %), minimally invasive suturing operations were performed, in 68 cases, laparotomy suturing (47.9 %), in three cases, gastric resection was performed (2.3 %). Comparative studies between groups have not been conducted. Clinical data regarding patient characteristics, surgical techniques, and complications were collected retrospectively.Results. Postoperative complications associated with operations for perforated gastroduodenal ulcers amounted to 26.8 %, or 38 cases. A univariate analysis showed that prolonged open surgical time in female patients≥60 years of age, as well as a high American Society of Anesthesiologists (ASA) score, and the presence of preoperative shock were significant perioperative risk factors for postoperative complications. Significant comorbid risk factors included hypertension, diabetes mellitus, and lung disease. Multivariate analysis showed that long operation times, open surgery, high ASA scores, and preoperative shock were independent risk factors for postoperative complications in perforated gastroduodenal ulcer.Conclusions. High ASA, preoperative shock, open surgery, and long operative times of more than 148 minutes are high risk factors for morbidity. However, there is no association between postoperative complications and comorbidity in patients with perforated ulcers.