An Impact of Helicobacter pylori Eradication after Simple Closure of Perforated Peptic Ulcer: A Prospective Randomized Trial

Authors

  • Petch Kasetsuwan Department of Surgery, Bhumibol Adulyadej Hospital, Phaholyothin Road, Donmeung, Bangkok 10220, Thailand
  • Somchai Thanasitthichai Department of Surgery, Bhumibol Adulyadej Hospital, Phaholyothin Road, Donmeung, Bangkok 10220, Thailand
  • Wanchai Krailadsiri Department of Surgery, Bhumibol Adulyadej Hospital, Phaholyothin Road, Donmeung, Bangkok 10220, Thailand

Abstract

Background: This study was carried out to evaluate the relationship of Helicobacter pylori (H. pylori) infection in perforated peptic ulcer patients and the benefit of H. pylori eradication on ulcer healing and ulcer recurrence after simple closure of perforated ulcer.

Materials and Methods: Sixty-six patients with perforated peptic ulcer were treated by simple closure with omental patch and intraoperative esophagogastroduodenoscopy (EGD) to assess H. pylori infection status. Patients were randomized into two groups; control group(group 1) received Omeprazole regardless of H. pylori status whereas the study group (group 2) H. pylori positive patients received a course of anti - H. pylori therapy. Follow-up EGD was performed at 2 months, and at I year after hospital discharge to evaluate ulcer healing and ulcer recurrence respectively.

Results: H. pylori infection rate was 86.3%, 50% and 92.8% in overall perforated ulcer, perforated gastric ulcer and perforated duodenal ulcer respectively. Ten patients did not return at 2 months for endoscopic follow-up. Of fifty-six patients, twenty-nine in group I and twenty-seven in group 2 underwent EGD at 2 months follow-up and revealed initial ulcer healing rate of 65.5% and 88.8% respectively (P =0 .038). At I year follow-up, ulcer recurrence rate of patients in group 1 was significantly higher than patients in group2 (36.8% and 5%, P = 0.02).

Conclusion: This study confirms a close relationship between H. pylori infection and perforated peptic ulcer. H. pylori eradication after simple closure and omental patch can promote initial ulcer healing and prevent ulcer recurrence as well. Immediate acid reduction surgery should be reserved only for patients who have obvious risk of gastric outlet obstruction.

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Published

2003-09-30

How to Cite

1.
Kasetsuwan P, Thanasitthichai S, Krailadsiri W. An Impact of Helicobacter pylori Eradication after Simple Closure of Perforated Peptic Ulcer: A Prospective Randomized Trial. Thai J Surg [Internet]. 2003 Sep. 30 [cited 2024 Nov. 23];24(3):85-90. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242951

Issue

Vol. 24 No. 3 (2003): July - September

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.