Helicobacter pylori infections - are these diseases relevant for surgical treatment?

Abstract

Helicobacter pylori infection and its strong association with gastroduodenal diseases has revolutionized our views and treatment options in these diseases. Surgery has always been considered a mainstay in their treatment. The development of potent eradication regimes has changed indications for operative treatment. With endoscopic procedures being increasingly performed by the surgeon himself, it has become necessary that he educate himself in the diagnosis and treatment of H. pylori infection in order to be able to cope with these diseases in every day surgical practice. Treatment of H. pylori infection may not only be seen as an alternative to operative therapy, but also as an adjunct following surgical treatment of gastroduodenal disease.

Is perforated marginal ulcer after the surgery of gastroduodenal ulcer associated with inadequate treatment for Helicobacter pylori eradication?

“…In the present study, all the patients had free air in the Cxr. The multiple factors that contribute to the development of MU are inadequate surgical procedures, ischemia secondary to gastrojejunostomy construction, unrecognized endocrine factors such as hyperparathyroidism, gastrinoma, staples, and nonabsorbable suture materials, ulcerogenic drugs such as NSAIDs, and H. pylori [1][2][3][4][5][6][7][8][9][10].…”

How <i>Helicobacter pylori</i> Changed the Life of Surgeons

“…Thus, over 92% of patients with gastric MALT lymphoma have active H. pylori infection [77]. There is general agreement that apart from localized disease (stage I), gastric MALT lymphoma should be treated by surgery [29, 78]if the tumor is potentially resectable. The extent of resection (subtotal or total gastrectomy) depends on the extent of the disease.…”

“…Surgery may only be indicated in situations where multiple eradication attempts have failed or with recurrent H. pylori -negative ulcers [29]. Therefore the role of the surgeon in the treatment of uncomplicated peptic ulcer has declined in recent decades to almost zero, beginning first with the development of potent acid-suppression drugs [30], and then further reduced by the identification and treatment of H. pylori .…”

“…Advanced disease may be treated by chemo- and/or radiotherapy. It has been strongly suggested to perform H. pylori eradication following surgery for gastric MALT lymphoma at all stages to prevent recurrence [29]. The appropriate treatment for localized (stage I) gastric MALT lymphoma is still controversial since high remission rates for these lymphomas have been observed following H. pylori eradication [79, 80].…”