Læknablaðið - 15.06.1998, Side 23
LÆKNABLAÐIÐ 1998; 84
473
bilinu 5-48% (2,5,16,22,29,30). En það er í
samræmi við hærri aldur sjúklinga með rofsár
auk annarra alvarlegra meðfylgjandi sjúkdóma.
Þá ályktun má draga af framanskrifuðu, að
sjúklingar sem koma inn á sjúkrahús með rof-
sár á maga og skeifugörn eru að stórum hluta
aldraðir og hafa aðra alvarlega sjúkdóma. Það
vekur athygli að enginn 22 sjúklinga sem tóku
bólgueyðandi gigtarlyf var á verndandi með-
ferð með magalyfjum. Kviðsjáraðgerð við rof-
sári á maga og skeifugarnarsári er sambærileg
við opna aðgerð. Við höfum snúið tæplega
helmingi kviðsjáraðgerða í opna aðgerð á þess-
um tíma. En meðferð með kviðsjáraðgerð virð-
ist stytta og einfalda gang eftir aðgerð og vafa-
laust mun takast að ljúka æ fleiri aðgerðum
með kviðsjá í framtíðinni með betri tækni og
æfingu.
HEIMILDIR
1. Cueto J, Weber A, Serrano F. Laparoscopic treatment of
perforated duodenal ulcer. Surg Laparosc Endosc 1993; 3:
216-8. '
2. Suter M. Surgical treatment of perforated peptic ulcer, is
there a need for a change? Acta Chir Belg 1993; 93: 83-7.
3. Champault GG. Laparoscopic treatment of perforated
peptic uicer. End Surg 1994; 2: 117-8.
4. Thors H, Sigurðsson H, Oddson E. Þjóðleifsson B. Að-
gerðir vegna sársjúkdóms í maga og skeifugöm. Lækna-
blaðið 1994; 80: 179-84.
5. Kaushik SP, Sikora SS. Perforated duodenal ulcer: is
definitive surgery warranted? Ind J Gastroenterol 1993;
12: 75-6.
6. Darzi A, Declan Carey P, Menzies-Gow N, Monson JRT.
Preliminary result of laparocopic repair of perforated
duodenal ulcers. Surg Laparosc Endosc 1993; 3: 161-3.
7. Ananthakrishna N, Angami K. Is ulcer recurrence after
smple closure of perforated duodenal ulcer predictable?
Ind J Gastroenterol 1993; 12:80-2.
8. Matsuda M, Nishiyama M, Hanai T, Saeki S, Watanabe T.
Laparoscopic omental patch repair for perforated peptic
ulcer. Ann Surg 1995; 221: 236-40.
9. Savage RL, Moller PW, Ballantyne CL, Wells JE. Varia-
tion in the risk of peptic ulcer complications with nonste-
roidal antiinflammatory drug therapy. Arthritis Rheum
1993; 36: 84-90.
10. Bateman DN. NSAIDs: time to re-evaluate gut toxicity
(letter). Lancet 1994; 343: 1051-2.
11. Thompson AR, Hall TJ. Anglin BA, Scott-Conner CEH.
Laparoscopic plication of perforated ulcer: Results of a
selective approach. South Med J 1995; 88: 185-9.
12. Bretagne JF, Raoul JL. Management of nonsteroidal anti-
inflammatory drug-induced upper gastrointestinal blee-
ding and perforation. Dig Dis 1995; 13/Suppl. 1: 89-105.
13. Siu WT, Leong HT, Li MKW. Single stitch laparoscopic
omental patch repair of perforated peptic ulcer. J R Coll
Surg Edinb 1997; 42: 92-4.
14. Blomberg LGM. Perforated peptic ulcer: Long-term Re-
sults after Simple Closure in the Elderly. World J Surg
1997;21:412-5.
15. Urbano D, Rossi M, De Simone P, Berloco P, Alfani D,
Cortesini R. Alternative laparoscopic management of
perforated peptic ulcers. Surg Endosc 1994; 8: 1208-11.
16. Svanes C, Salvesen H, Stangeland L, Svanes K, Spreide O.
Perforated peptic ulcer over 56 years. Time trend in patients
and disease characteristics. Gut 1993; 34: 1666-71.
17. Reinbach DH, Cruickshank G, McColl KEL. Acute perfo-
rated duodenal ulcer is not associated with Helicobacter
pylori infection. Gut 1993; 34: 1344-7.
18. Wolfe F. The Epidemiology of NSAID Associated Gas-
trointestinal Disease. Eur J Rheumatol Inflamm 1991; 11:
12-28
19. Glarborg Jprgensen T. Drug consumption before perfora-
tion of peptic ulcer. Br J Surgl977; 64: 247-9.
20. Graham DY. Nonsteroidal Anti-Inflammatory Drugs,
Helicobacter pylori, and Ulcers: Where we stand. Am J
Gastroenterol 1996; 91: 2080-5
21. Jibril JA, Redpath A, Macintyre IMC. Changing pattern of
admission an doperation for duodenal ulcer in Scotland.
Br J Surg 1994; 81: 87-9.
22. Wakyama T, Ishizaki Y, Mitsusada M, Takahashi S, Wada
T, Fukushima Y, et al. Risk factors influencing the short-
term results of gastroduodenal perforation. Surgery Today,
JpnJSurg 1994; 24: 681-7.
23. Mouret P, Fran?ois Y, Vignal J, Barth X, Lombard-Platet
R. Laparoscopic treatment of perforated peptic ulcer. Br J
Surg 1990; 77: 1006
24. Sunderland GT, Chisholm EM, Lau WY, Chung SCS, Li
AKC. Laparoscopic repair of perforated peptic ulcer. Br J
Surg 1992; 79: 785.
25. Benoit J, Champault GG, Lebhar E, Sezeur A. Suturless
laparoscopic treatment of perforated duodenal ulcer
(letter). BrJ Surg 1993; 80: 1212.
26. Isaac J, Tekant Y, Kiong KC, Ngoi SS, Goh P. Laparo-
scopic repair of duodenal ulcer. Gastrointest Endosc 1994;
40: 68-9.
27. Dobemeck RC. Limited operation for bleeding or perfora-
ted gastric ulcer in high risk patients. Am Surg 1993; 59:
472-4.
28. Hewitt PM, Krige J, Bornman PC. Perforated gastric ul-
cers: Resection compared with simple closure. Am Surg
1993; 59:669-73.
29. Paimela H, Joutsi T, Kiviluoto T, Kivilaakso E. Recent
trend in mortality from peptic ulcer disease in Finland.
Dig Dis Sci 1995; 40: 631-5.
30. Lehnert T, Herfarth C. Peptic ulcer surgery in patients
with liver cirrhosis. Ann Surg 1993; 27: 338-46.
31. Wu CW, Kung SP, Liu M, Hsieh MJ, Lui WY, P’eng FK.
Gastrojejunal disconnection in the presence of purulent
peritonitis as an alternative approach in gastroduodenal
operations. Surg Gynecol Obstet 1993; 177: 188-90.