Surgical management of perforated peptic ulcer disease.
BACKGROUND
Surgery for perforated peptic ulcer disease is one of the most common emergency procedures carried out in the western world. The role of postoperative empiric Helicobacter Pylori eradication therapy is controversial.


METHODS
The clinical, operative and postoperative surveillance details of 84 consecutive patients who underwent surgery for perforated peptic ulcer were reviewed.


RESULTS
All patients underwent omentopexy +/- simple closure followed by proton pump therapy. Patients were followed-up for an average of 44 +/- 19 months. Females were older than male patients (59 +/- 20 vs. 46 + 17 years; p<0.05), presented with symptoms of a longer duration (17.9 +/- 16 vs. 8.9 +/- 9 hours; p=0.045) and had a higher mortality rate (18% vs 3%; p<0.05). Seventy-nine per cent of patients received postoperative empiric Helicobacter Pylori eradication therapy.


CONCLUSIONS
Surgery for perforated peptic ulcer is associated with a significant perioperative mortality rate. Elderly female patients are particularly at risk.
Sweeney
K J
KJ
Dept of Surgery, Mater Misericordiae Hospital, Dublin. karlsweeney@eircom.net
Faolain
M O
MO
Gannon
D
D
Gorey
T F
TF
Kerin
M J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis; D010439:Peptic Ulcer Perforation / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D015996:Survival Rate
D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors