Surgical treatment of ulcer disease 5 years before and after the introduction of cimetidine
Rohner, H.G.; Blömer, A.; Echterhoff, H.M.; Gugler, R.
Zeitschrift für Gastroenterologie 21(10): 585-592
1983
ISSN/ISBN: 0044-2771 PMID: 6649737 Document Number: 219731
To determine whether H2-antagonists have changed type and frequency of operations for peptic ulcer, all operations of the one hospital of a city with a population of 80 000 were analysed. The total number of operated patients decreased after cimetidine from 425 to 278 (35%). The ratio of male to female patients was 3:1 in either period. While the decrease in elective operations of uncomplicated ulcer was 51%, operations in patients with ulcer complications (bleeding, perforation, stenosis) decreased by only 9%. The decrease was above average in Billroth I and Billroth II gastrectomy, but the number of patients with selective vagotomy increased 3-fold. The number of operations decreased by 40% for duodenal ulcer and by 20% for gastric ulcer. Of all ulcer complications bleeding decreased by 31%, the number of perforations was unchanged, but the number of patients with stenosis increased by 58%. Overall mortality decreased from 25 in the initial to 20 in the subsequent five year period. Twenty and 19 patients, respectively, died with complicated ulcer disease (12,5% of all operations), mortality was 6 (1,5%) with operations for uncomplicated ulcer.