Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Lau, James Y.; Sung, Joseph J.Y.; Hill, Catherine; Henderson, Catherine; Howden, Colin W.; Metz, David C.

doi:10.1159/000323958

Cited by 460 publications

(413 citation statements)

References 172 publications

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“…pylori has been identified as the most important risk factor for peptic ulcer disease [15,16] . Significant decrease in the rate of ulcer recurrence was reported in patients with perforated peptic ulcer following simple closure and eradication of H. pylori [2,15] . However, the choice of the optimal regimen for H. pylori eradication is debated [17] .…”

Section: Discussionmentioning

confidence: 99%

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Gopal

Elamurugan²,

Kate³

et al. 2013

WJGPT

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AIM:To compare the eradication rates for Helicobacter pylori (H. pylori ) and ulcer recurrence of standard triple therapy (STT) and levofloxacin based therapy (LBT). METHODS:Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid , clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid , levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d each. The H. pylori eradication rates, side effects, compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow up. RESULTS:Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo fol-

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Section: Discussionmentioning

confidence: 99%

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Gopal

Elamurugan²,

Kate³

et al. 2013

WJGPT

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“…High rates of morbidity (20%-50%) and mortality (3%-40%) have been reported for patients surgically treated for PUP (11)(12)(13)(14). There are many studies about the risk factors for these high mortality and morbidity rates.…”

Section: Discussionmentioning

confidence: 99%

Is it possible to reduce the surgical mortality and morbidity of peptic ulcer perforations?

Hut

Tatar²,

Dogan

et al. 2017

Turk J Surg

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INTRODUCTIONWith regard to creating a novel vision for former diseases, our memorizationsshould be updated. Some diseases and their outcomes, which have been previously very well known, are nowadays almost always presented as unexpected cases because of new technologies and evolvements in medicine due to resistant events. Thus, antiulcer medication and presentation of elderly patients have changed in peptic ulcer perforation (PUP) and, transforming the patient profiles with PUP in our era. Therefore, a novel vision to avoid gaps is necessary to evaluate the patients with PUPsas surgeons are coming across newer patient profiles in last decades. Peptic ulcers are focal defects in the stomach and the duodenum extending below the mucosa or deeper (1, 2). They can be acute or chronic; the etiology of the condition is the disruption of balance between gastric acid effect and mucosal defense mechanisms (2, 3). Although medical treatments such as H2 receptor antagonists, proton pump inhibitors, and Helicobacter pylori eradication through antibacterial drugs, have decreased the number of surgeries in non-complicated peptic ulcer cases, the number of patients presenting to the emergency clinics with peptic ulcer perforation has not decreased (1-5).Peptic ulcer perforation is still an important health problem, despite the decreasing incidence of peptic ulcer disease. The aim of this study was to investigate factors affecting the mortality and morbidity of PUPs and specifically determine approaches to decrease mortality. MATERIAL AND METHODSThe data from 112 patients operated with the diagnosis of PUP at our Training and Research Hospital between January 2010 and December 2015 were retrospectively analyzed. Patient age, gender, weight, height, American Society of Anesthesiologists (ASA) score, symptoms, time interval between symptom onset and surgery, accompanying diseases, length of hospital stay, operative technique, laboratory findings, site and diameter of perforation, Acute Physiology and Chronic Health Evaluation (APACHE) II and Mannheim Peritonitis Index (MPI) scores, preoperative shock state, morbidity, and mortality were recorded. MPI (Table 1) and APACHE II scores were calculated for all patients. Patient age, chronic health status, rectal temperature, mean arterial blood pressure, heart rate, respiratory rate, arterial pH, partial oxygen pressure, serum sodium, serum potassium, serum creatinine, hematocrit, white blood cell count, and Glasgow coma score were recorded for determining the APACHE II score. 267Objective: Peptic ulcer perforation is a life-threatening situation requiring urgent surgical treatment. A novel vision in peptic ulcer perforation is necessary to fill the gaps created by antiulcer medication, aging of the patients, and presentation of resistant cases in our era. In this study, we aimed to share our findings regarding the effects of various risk factors and operative techniques on the mortality and morbidity of patients with peptic ulcer perforation. Material and Methods:Data from 112 patient...

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“…The incidence of PUD has been 1.5% -3% (2). Although 10% -20% of the patients with history of PUD will complicate, out of this 2% -14% patient will have perforation peritonitis (3)(4)(5). Patients with PUD perforation carries high risk of mortality and morbidity (6).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

Babu

Raikhy

Ghosh

et al. 2017

J Minim Invasive Surg Sci

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Background: Laparoscopic repair of duodenal perforation using the omental patch is one of the traditional techniques, which gives better postoperative recovery in patients with little chances of abdominal wound infection. This article is about the technique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique. Methods: In Hanging method of duodenal repair first, an intra-corporeal suture is taken at the upper margin of perforation and both end of the thread is taken out of anterior abdominal wall and duodenum is pulled up. Now under vision the next two parallel sutures are passed, thus avoiding the posterior duodenal wall incorporation. Finally omentum flap is used for the closure of perforation. Conclusions:The laparoscopic closure of the duodenal perforation by "Hanging Method" is an appropriate Laparoscopic technique, as "hanging" the anterior wall of duodenum gives us better vision of the posterior wall of duodenum, while taking the suture through anterior duodenal wall. Further since the gall bladder is retracted there is an easy available working space for intracorporeal suturing.

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Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Cited by 460 publications

References 172 publications

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Is it possible to reduce the surgical mortality and morbidity of peptic ulcer perforations?

Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

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