Surgical management of peptic ulcer disease in proton pump inhibitor era

ABSTRACT

To evaluate the important risk factors involved in complications of peptic ulcer disease and the need, timing, extent and outcome of surgery with the evolution of proton pump inhibitors. Descriptive study. POF Hospital Wah Cantt, from December 2006 to December 2008. All the patients presenting with complications of peptic ulcer disease [perforation, bleeding duodenal ulcers and gastric outlet obstruction] were included in this study. A total of 46 patients were included in this study. Thirty five patients had peptic ulcer perforation, 8 patients presented with bleeding peptic ulcer that failed to respond to medical and endoscopic treatment and 3 patients presented with gastric outlet obstruction. Smoking was the most common risk factor followed by the use of non streroidal anti inflammatory [NSAID] drugs and steroids. Ramadan fasting was also a factor in patients with history of dyspepsia. Peptic ulcer perforation was more common in patients in second and third decade of life as compared to bleeding which was more prevalent in fourth decade. Modern medical and endoscopic therapy has caused a decline in complications of peptic ulcer disease but they are still prevalent in developing world. Smoking is one of the most common and important risk factors