title: Peptic ulcer complications requiring surgery: what has changed in the last 50 years in Turkey.
abstract: OBJECTIVE
  The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications.
  
  
  METHODS
  This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012.
  
  
  RESULTS
  In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001).
  
  
  CONCLUSIONS
  From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Teaching and ResearchHospital, Ankara, Turkey. hakanguzel@gmail.com.
authors.forename: Hakan
authors.initials: H
authors.lastname: Güzel
authors.forename: Sahin
authors.initials: S
authors.lastname: Kahramanca
authors.forename: Duray
authors.initials: D
authors.lastname: Şeker
authors.forename: Gülay
authors.initials: G
authors.lastname: Özgehan
authors.forename: Gündüz
authors.initials: G
authors.lastname: Tunç
authors.forename: Tevfik
authors.initials: T
authors.lastname: Küçükpınar
authors.forename: Hülagü
authors.initials: H
authors.lastname: Kargıcı
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000453:epidemiology* / Q000601:surgery; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors