Postoperative Outcomes and Their Determinants in Perforated Duodenal Ulcers

Abstract

Background: Perforated peptic ulcer remains a serious surgical emergency associated with considerable postoperative morbidity and mortality, particularly in patients presenting late with peritonitis, sepsis, advanced age, malnutrition, or multiple comorbidities. Postoperative outcomes are influenced by several interrelated patient-, disease-, procedure-, and healthcare-related factors. Early complications include surgical-site infection, intra-abdominal abscess, anastomotic leakage, respiratory complications, septicemia, and multiorgan failure, whereas long-term outcomes may involve recurrent ulceration, gastric outlet obstruction, impaired functional recovery, and reduced quality of life. Surgical technique, timing of intervention, physiological condition at presentation, nutritional status, Helicobacter pylori eradication, perioperative critical care, and implementation of enhanced recovery protocols may substantially affect recovery, hospital stay, recurrence, and survival. This review discusses the principal postoperative outcomes following surgery for perforated peptic ulcer and summarizes the major determinants associated with favorable and poor prognosis.