ABSTRACT
Background: Peptic ulcer was defined as a disruption of the mucosal integrity of the abdominal esophagus, stomach, duodenum leading to local defect or excavation due to active inflammation. Hospitalizations for peptic ulcer disease (PUD) have decreased since the advent of specific medical therapy & low tachyphylaxis associated with those drugs. This study aims to evaluate the surgical complications of peptic ulcer disease and tested the hypothesis that despite the decrease in hospitalization for PUD, the incidence of elective surgery for PUD during the recent three decades tends to decrease and in contrast, the frequency of emergency surgical interventions for complications of the PUD has remained consistent.Methods: A total of 60 patients operated for complications of PUD, admitted to PES Institute of Medical Sciences, Kuppam, from January 2018 to September 2019. All data that may be potential predictors concerning complications of PUD were prospectively analyzed.Results: In the present study, the most common complication was perforated peptic ulcer (78.3%) followed by Gastric outlet obstruction (15%) and rest bleeding peptic ulcer.Conclusions: Despite the efficacy of modern medical therapy, decreasing the overall PUD hospitalizations, the volume of procedures to treat complications of PUD has not declined.
ABSTRACT
Objective To evaluate the effect of simple closure operation followed by anti-Helicobacter pylori(Hp)therapy for perforated peptic ulcer. Methods 168 cases of perforated peptic ulcer treated by simple closure operation with or without postoperative medication therapy were followed-up and analyzed. Results 1 year after operation, the recurrence rate of peptic ulcer was 3.8% in the group of standard anti-Hp therapy(S group), and that of gastric and duodenal ulcer in S group was 8.3% and 3.6%,respectively; while it was 62.9%, 66.7% and 58.8% in the group of non-standard Hp therapy (N-S group), and 88.9%, 100% and 80.0% in the group without Hp therapy (NT group).The diffcrence of reccurrence rate of peptic ulcer between S group with N-S group?NT group was significant(P
ABSTRACT
If peptic ulcer perforates in the presence of shock or concurrent medical disease or delay of operation, the postoperative morbidity and mortality are high. Years ago most discussion was on whether urgent definite surgery was the most effect therapy, nowadays there is a tendency to less invasive measures in risk situation. Although the simple closure or omental patching has its weak point of high frequency of symptomatic relapse, it is a simple and safe method with the advantage of having a low complication rate than other definite operations. So many surgeons frequently use this simple method in high risk situation. But in the rare instance of large perforation of prepyloric ulcer, this simple closure method is not safe to apply. The authors experienced an unusual case of large prepyloric ulcer perforation in an 80 year old female who had undergone a previous operation(choledocho-duodenostomy). Moreover she had suffered from several concurrent medical diseases and the operation was delayed. We succeeded in repairing the perforation using controlled gastrostomy and omental patching method, and present this case with a review of the literature.