Variations reported in surgical practice for bleeding duodenal ulcers

BackgroundTo determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed.MethodsFAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had recertified in general surgery (RECERT) were compared with young FAC who had not and RES (RES/young FAC). Two-group comparisons were performed.ResultsSeventy-three percent of FAC and 62% of RES responded. RES perform more ARPs on hemodynamic (HD), unstable, elderly patients than FAC (P = .013). On the elderly patient, RES/young FAC perform more ARPs in a HD stable (P = .07) and unstable condition (P = .18). HD unstable patients would undergo OS more frequently than stable patients (P = .016).ConclusionsIn this survey, the choice of optimal surgical procedure for an acute bleeding ulcer varies among surgeons based on years of surgical experience and individual patient factors.