Perforated peptic ulcer: a deliberative approach.

Between 1966 and 1987, 116 patients with 119 episodes of perforation were admitted to Box Hill Hospital into one surgical unit, and 91 patients with 92 episodes were admitted into the other, with patients being admitted in alternate weeks. In the former unit, in order to avoid surgery in those patients whose ulcers had sealed spontaneously, a deliberative approach was followed according to a strict protocol--involving a deliberate time delay in surgical decision-making. In the latter unit, a more conventional approach was adopted, and patients in that unit are used as a retrospective comparison.