Effects of some factors on the indication for surgical treatment of gastroduodenal ulcer disease.
The author of the present communication collected a variety of important information on 2,173 patients living permanently in Prague 4. In all of them the diagnosis of gastroduodenal ulcer disease was established between 1979 and 1988 incl. The results obtained by the currently applied therapy were not designated as satisfactory both by the patient and by his doctor. The predomination of conservative therapy was due to the introduction of new drugs which reduce markedly gastric secretion of HCl. On the basis of strict indications elective surgery was advised in some patients. In the acute stage of the disease (bleeding, perforation, stenosis) clearly defined criteria allowed to establish the indication for elective surgery. The answer to this question provides the author in the form of a scheme of the regimen which should be observed after a definite diagnosis. It was devised on the basis of the results of the present study, of reports in the Czech and international literature, as well as of our own experience. For the indication of surgical treatment is of great importance a high degree of responsibility of the doctor. This is reflected by the correct choice of the optimum surgical procedure. Good results obtained in the management of ulcer disease were due to the fact that attention was paid to the often neglected aspect of the psychosomatic character of this disease.