Surgical management of peptic ulcer disease

Wang, Alice; Yerxa, John; Agarwal, Suresh; Turner, Megan C.; Schroder, Vanessa T.; Youngwirth, Linda M.; Lagoo‐Deenadayalan, Sandhya; Pappas, Theodore N.

doi:10.1016/j.cpsurg.2019.100728

Cited by 24 publications

(30 citation statements)

References 236 publications

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“…The fact that the major etiologies of PUP are similar worldwide due to the high prevalence of H. pylori infection and the use of non-steroidal anti-inflammatory drugs may help clarify this finding. 35 , 36 …”

Section: Discussionmentioning

confidence: 99%

“…Peptic ulcer perforation (PUP) is a life-threatening surgical condition that occurs in 2–20% of peptic ulcer disease patients and may increase mortality by up to 24–30%. 1 , 2 Giant PUP is a perforation ≥ 2 cm, resulting in extensive tissue loss and severe tissue inflammation of the gastric or duodenal wall. 3 , 4 These effects may preclude the ulcer from healing following surgical repair and lead to increased postoperative morbidities (such as bile leakage and intraabdominal collection) and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Does Omental Plugging Provide a Better Surgical Treatment Outcome than the Omentopexy Technique in the Management of Giant Peptic Ulcer Perforation? A Meta-analysis of Comparative Studies

Tullavardhana¹,

Chartkitchareon²

2022

Oman Med J

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Objectives: Giant perforation (size > 2 cm) is a catastrophic complication of peptic ulcer disease, which is difficult to repair and leads to postoperative leakage and 60% morbidity and 48.2% mortality rates. The objective of this meta-analysis was to compare the postoperative outcomes of omental plugging and omentopexy in the treatment of giant ulcer perforation. Methods: The dataset was defined by searching for articles published until December 2020 from PubMed, Embase, Google Scholar, and the Cochrane database. The search terms included were giant peptic ulcer, peptic ulcer perforation, omentopexy, and omental plug. The data analysis included a study published in English that evaluated the surgical outcomes of omental plugging and omentopexy in the management of giant peptic ulcer perforation patients. Meta-analysis was performed using Review Manager software version 5.4.1. Results: A total of 175 articles were identified during the initial search. After review, eight articles were suitable for inclusion in the meta-analysis. A total of 367 patients were included in the final analysis. The findings demonstrate that when compared to the omentopexy group, the omental plugging technique significantly reduced overall postoperative complications (odds ratio (OR) = 0.29, 95% CI: 0.18–0.47, p =0.0001) and bile leakage rate (OR = 0.18, 95% CI: 0.07–0.46, p =0.0003), resulting in a significantly lower postoperative mortality rate (OR = 0.35, 95% CI: 0.17–0.69, p =0.003). However, there was no significant difference in intraabdominal collection, respiratory tract, and wound infection rates between each surgical treatment group. Conclusions: Omental plugging is a simple surgical procedure associated with fewer postoperative complications and mortality than omentopexy. This technique is a safe surgical treatment option for peptic ulcer perforations > 2 cm.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does Omental Plugging Provide a Better Surgical Treatment Outcome than the Omentopexy Technique in the Management of Giant Peptic Ulcer Perforation? A Meta-analysis of Comparative Studies

Tullavardhana¹,

Chartkitchareon²

2022

Oman Med J

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“…Perforation, as a result of full-thickness ulceration, which will invariably cause intra-abdominal sepsis and require operative intervention with subsequent ICU admission for the management of distributive shock. 2 Severe hemorrhage as a result of peptic ulcer disease will typically manifest clinically with some combination of epigastric pain, tachycardia, hypotension, and anemia, as well as hematemesis or blood per rectum. Management is focused on hemodynamic stabilization, correction of the underlying coagulopathy, and airway protection with endotracheal intubation in patients at risk for aspiration as a result of hematemesis.…”

Section: Gastroenterological Surgical Emergencies Peptic Ulcer Diseas...mentioning

confidence: 99%

Surgical Emergencies in the ICU

Saini

Ashraf

Babowice

et al. 2023

Critical Care Nursing Quarterly

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Surgical emergencies are common in the critical care setting and require prompt diagnosis and management. Here, we discuss some of the surgical emergencies involving the gastrointestinal, hepatobiliary, and genitourinary sites. In addition, foreign body aspiration and necrotizing soft-tissue infections have been elaborated. Clinicians should be aware of the risk factors, keys examination findings, diagnostic modalities, and medical as well as surgical treatment options for these potentially fatal illnesses.

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“…In most cases, the clinical symptoms of gastric cancer and gastric ulcers are similar. Upper abdominal pain is the most common clinical symptom in 81% of patients with upper peptic ulcers [4] . It is often necessary to consider the patient's clinical symptoms, diagnostic imaging, and gastroscopy findings to determine the nature of the gastric lesion in clinical practice.…”

Section: Introductionmentioning

confidence: 99%