Surgical perspectives in peptic ulcer disease and gastritis.
For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery, patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understanding of the impact of H pylori has led to a trend towards minimalism in surgical therapy for complicated peptic ulcer disease. In addition to the changes in patient care, these developments have had an impact on the training of surgeons. This article outlines these trends and developments.
Lipof
Tamar
T
Department of Surgery, University of Connecticut School of Medicine, 263 Farmington Avenue, MC 3955 Farmington, CT 06030-3955, USA.
Shapiro
David
D
Kozol
Robert-A
RA
D013505:Digestive System Surgical Procedures / Q000379:methods / Q000639:trends; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D054328:Proton Pump Inhibitors
D054328:Proton Pump Inhibitors