Treatment of perforated peptic gastric and duodenal ulcers in conditions of late admission

The results of treatment of 65 patients with perforated peptic ulcer who were treated at the General Surgery Clinic of Volgograd State Medical University, based on Volgograd Regional Clinical Hospital No1, in the period 2017–2023 were analyzed. More than half of the patients [55 % (n = 36)] were admitted to the surgical hospital later than 24 hours after the onset of the disease. Depending on the time of hospitalization (before and after 24 hours), the mortality rate for perforated ulcers is 0 % and 44.7 %, the incidence of postoperative complications is 14 % and 50 %, respectively. In conditions of late admission, the proportion of minimally invasive operations was 12 %. An assessment of the motivation factors of surgeons when choosing the type of surgery showed that laparotomy interventions are preferred due to the presence of diffuse purulent peritonitis, due to hypotension and contraindications to the creation of a tense pneumoperitoneum and due to the combined complications of peptic ulcer disease.