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


AYDINLI B., Yilmaz O., ÖZTÜRK G., Yildigan M., Gursan N., Basoglu M.

LANGENBECKS ARCHIVES OF SURGERY, vol.392, no.5, pp.593-599, 2007 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 392 Issue: 5
  • Publication Date: 2007
  • Doi Number: 10.1007/s00423-007-0167-4
  • Journal Name: LANGENBECKS ARCHIVES OF SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.593-599
  • Ondokuz Mayıs University Affiliated: No

Abstract

Background and aims A marginal ulcer developing after an initial operation for gastroduodenal ulcer is a serious threat to the patient, and a challenge to surgeons. Helicobacter pylori is the primary cause of peptic ulcer disease. However, its role in ulcer recurrence, especially of marginal ulcer (MU), after peptic ulcer surgery is unclear. This study aimed to determine any association between H. pylori infection and perforated MU by comparing the prevalence of H. pylori and nonsteroidal anti-inflammatory drugs (NSAIDs) use in patients with perforated (PMU) and in those with nonperforated MU (NPMU). Study design The study retrospectively evaluated the records of 16 patients with PMU who underwent surgical treatment and 24 patients with NPMU who underwent medical treatment in Ataturk University, School of Medicine, Department of General Surgery and Gastroenterology, between January 1995 and December 2004. Results The rate of H. pylori in the PMU group was significantly higher than that of the NPMU group (P < 0.01). There was a significant relationship between NSAID consumption and PMU compared with NPMU patients (P < 0.01). There was also a significant relationship between NSAID consumption and H. pylori and PMU (P < 0.01). Conclusion Eradication of H. pylori after the first PMU operation especially in cases with impaired hemodynamics, severe peritoneal contamination, and/or a diameter smaller than 1 cm and avoiding the use of NSAIDs will surely reduce the risk of relapsing ulcers.