Surgical management of complicated ulcer disease.

The advent of excellent acid-suppressing medications and the not-so-recent realization of the importance of Helicobacter pylori have markedly altered the physician's management of ulcer-related problems. Although the investigation of acid-peptic disorders helped to launch the modern understanding of abdominal surgery, the majority of operative interventions are now aimed at managing emergent problems that arise from ulcers. There are a waning number of surgeons with extensive experience in the operations that will be described in this report. The global management of patients who suffer from ulcer-related problems will require close cooperation among and between specialties, as well as clear understanding of our respective capabilities and limitations.