title: Eradication of Helicobacter pylori for prevention of ulcer recurrence after simple closure of perforated peptic ulcer: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Eradication of Helicobacter pylori has become part of the standard therapy for peptic ulcer. However, the role of H pylori eradication in perforation of peptic ulcers remains controversial. It is unclear whether eradication of the bacterium confers prolonged ulcer remission after simple repair of perforated peptic ulcer.
  
  
  METHODS
  A systematic review and meta-analysis of randomized controlled trials was performed to evaluate the effects of H pylori eradication on prevention of ulcer recurrence after simple closure of perforated peptic ulcers. The primary outcome to evaluate these effects was the incidence of postoperative ulcers; the secondary outcome was the rate of H pylori elimination.
  
  
  RESULTS
  The meta-analysis included five randomized controlled trials and 401 patients. A high prevalence of H pylori infection occurred in patients with perforated peptic ulcers. Eradication of H pylori significantly reduced the incidence of ulcer recurrence at 8 wk (risk ratio 2.97; 95% confidence interval: 1.06-8.29) and 1 y (risk ratio 1.49; 95% confidence interval: 1.10-2.03) postoperation. The rate of H pylori eradication was significantly higher in the treatment group than in the nontreatment group.
  
  
  CONCLUSIONS
  Eradication therapy should be provided to patients with H pylori infection after simple closure of perforated gastroduodenal ulcers.
authors.affiliation: Department of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chung-Shun
authors.initials: CS
authors.lastname: Wong
authors.forename: Chee-Fah
authors.initials: CF
authors.lastname: Chia
authors.forename: Hung-Chia
authors.initials: HC
authors.lastname: Lee
authors.forename: Po-Li
authors.initials: PL
authors.lastname: Wei
authors.forename: Hon-Ping
authors.initials: HP
authors.lastname: Ma
authors.forename: Shin-Han
authors.initials: SH
authors.lastname: Tsai
authors.forename: Chih-Hsiung
authors.initials: CH
authors.lastname: Wu
authors.forename: Ka-Wai
authors.initials: KW
authors.lastname: Tam
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence