A perforated peptic ulcer is treated by all except
The most impoant component of the operation of perforated peptic ulcer is a thorough peritoneal toilet to remove all of the fluid and food debris. If the perforation is in the duodenum it can usually be closed by several well-placed sutures, closing the ulcer in a transverse direction as with a pyloroplastyIf the perforation is difficult to close primarily itis frequently possible to seal the leak with an omental patch (Graham patch) alone, and many surgeons now employ this strategy for all perforations.In the past, many surgeons performed definitive procedures such as either truncal vagotomy and pyloroplasty or, more recently and probably more successfully, highly selective vagotomy during the course of an operation for a perforation.Following operation,gastric antisecretory agents should be staed immediately. H.pylori eradication is mandatory.Under-running of a vessel is done in peptic ulcer bleedingBailey and love pg: 1126
Under running of vessel
H.pylori eradication
Highly selective Vagotomy
Omental patch
G.I.T