Decreasing need for elective peptic ulcer disease surgery.
BACKGROUND
With the advent of potent gastric acid suppressing drugs and antibiotics effective against Helicobacter pylori, the rate of surgical operations for the treatment of peptic ulcer disease (PUD) and its complications have drastically fallen.


OBJECTIVE
To audit our experience with this disease and its operative treatment at the surgical services of one tertiary health institution in Nigeria.


METHODS
A-5-year retrospective audit (January 2000-December 2004) of all hospital admissions of PUD managed at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. The case folders of those who were surgically treated were subsequently isolated and further analyzed in detail. Data collected included patient's demographics, clinical details, indication for surgical treatment, operation report and outcome of care.


RESULTS
Out of 624 patients admitted with a clinical diagnosis of peptic ulcer disease into the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto during the study period, 21 (3%) were surgically treated. Of this subpopulation, 18 were males and three females; giving a sex ratio of 6:1. Their ages ranged between 30 and 62 years with a mean of 40.8 years. Thirteen (62%) of the patients had emergency procedures for life threatening complications of the disease. The remainder were operated electively. All but one survived representing a mortality rate of 4.8%.


CONCLUSIONS
Elective peptic ulcer surgery has decreased in comparison with the emergency procedures in our centre. The advent of effective antibiotics against Helicobacter pylori and the use of potent gastric acid suppressing drugs may relegated the surgical approach to the treatment of PUD to history someday in the 21st century.
Mbah
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Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, P. M. B. 2370, Sokoto, Nigeria. nonsodr@yahoo.co.uk
Opara
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Adesanya
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D000328:Adult; D017677:Age Distribution; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009549:Nigeria; D010437:Peptic Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult