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Titolo:
Prevalence of Helicobacter pylori infection in peptic ulcer perforations
Autore:
Metzger, J; Styger, S; Sieber, C; von Fliie, M; Vogelbach, P; Harder, F;
Indirizzi:
Univ Basel Hosp, Dept Surg, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 rg, CH-4031 Basel, Switzerland Univ Basel Hosp, Gastrointestinal Unit, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 it, CH-4031 Basel, Switzerland Cantonal Hosp Luzern, Surg Serv, Luzern, Switzerland Cantonal Hosp LuzernLuzern Switzerland Surg Serv, Luzern, Switzerland Spital Dornach, Chirurg Klin, Dornach, Switzerland Spital Dornach Dornach Switzerland , Chirurg Klin, Dornach, Switzerland
Titolo Testata:
SWISS MEDICAL WEEKLY
fascicolo: 7-8, volume: 131, anno: 2001,
pagine: 99 - 103
SICI:
1424-7860(20010224)131:7-8<99:POHPII>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
OMENTAL PATCH REPAIR; DUODENAL-ULCER; LAPAROSCOPIC REPAIR; TRIPLE THERAPY; SIMPLE CLOSURE; ERADICATION; DISEASE; CLARITHROMYCIN; METRONIDAZOLE; OMEPRAZOLE;
Keywords:
H. pylori infection; peptic ulcer disease; perforated ulcers; H. pylori eradication; laparoscopic repair;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Metzger, J Univ Basel Hosp, Dept Surg, Spitalstr 21, CH-4031 Basel, Switzerland Univ Basel Hosp Spitalstr 21 Basel Switzerland CH-4031 zerland
Citazione:
J. Metzger et al., "Prevalence of Helicobacter pylori infection in peptic ulcer perforations", SWISS MED W, 131(7-8), 2001, pp. 99-103

Abstract

Background: Most patients with chronic peptic ulcer disease have Helicobacter pylori (H. pylori) infection. In the past, immediate acid-reduction surgery has been strongly advocated for perforated peptic ulcers because of the high incidence of ulcer relapse after simple closure. Simple oversewing procedures either bq an open or laparoscopic approach together with H. pylori eradication appear to supersede definitive ulcer surgery. Methods: In 47 consecutive patients (mean age = 64 years, range 27-91) suffering from acute peptic ulcer perforation the preoperative presence of H. pylori (CLO test), the surgical procedure (laparoscopy or open surgery), the outcome of surgery, and the success of EI. pylori eradication with a triple regimen were prospectively studied. Results: Of these patients 73.3% were positive for H. pylori, regardless of the previous use of nonsteroidal anti-inflammatory drugs (NSAIDs). Thirty-eight per cent underwent a simple laparoscopic repair. Conversion rate to laparotomy reached a high of 32%. The main reasons for conversion were the size of the ulcer, and/or diffuse peritonitis for a duration of over 12 hours with fibrous membranes difficult to remove laparoscopically. In the H. pylori positive patients, eradication was successful in 96% of the cases. Mortality and morbidity rates were greater in the laparoscopic group (p < 0.05). Follow-up (median 43.5 months) revealed no need for reoperation for peptic ulcer disease and no mortality. Conclusion: We have found a high prevalence of H. pylori infection in patients with perforated peptic ulcers. An immediate and appropriate H. pylori eradication therapy for perforated peptic ulcers reduces the relapse rate after simple closure. Response rate to a triple eradication protocol was excellent in the hospital setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 08:13:18