A study on surgical complications of peptic ulcer disease: a prospective study at a tertiary care center
Keywords:Peptic ulcer disease, Complications of peptic ulcer disease, Peptic ulcer perforation, Simple closure, Omentoplasty
Background: Peptic ulcer was defined as a disruption of the mucosal integrity of the abdominal esophagus, stomach, duodenum leading to local defect or excavation due to active inflammation. Hospitalizations for peptic ulcer disease (PUD) have decreased since the advent of specific medical therapy & low tachyphylaxis associated with those drugs. This study aims to evaluate the surgical complications of peptic ulcer disease and tested the hypothesis that despite the decrease in hospitalization for PUD, the incidence of elective surgery for PUD during the recent three decades tends to decrease and in contrast, the frequency of emergency surgical interventions for complications of the PUD has remained consistent.
Methods: A total of 60 patients operated for complications of PUD, admitted to PES Institute of Medical Sciences, Kuppam, from January 2018 to September 2019. All data that may be potential predictors concerning complications of PUD were prospectively analyzed.
Results: In the present study, the most common complication was perforated peptic ulcer (78.3%) followed by Gastric outlet obstruction (15%) and rest bleeding peptic ulcer.
Conclusions: Despite the efficacy of modern medical therapy, decreasing the overall PUD hospitalizations, the volume of procedures to treat complications of PUD has not declined.
Ronald F, Martin, MD. Surgical management of ulcer disease. Surg Clini North Am. 2005;85:907-29.
Towfigh S, Chandler C, Hines OJ, Mcfadden DW. Outcomes from peptic ulcer surgery have not benefited from advances in medical therapy. Am Surg, 2002;68:385-9.
Jamieson GG. Current status of indications for surgery in peptic ulcer disease. World J Surg 2000; 24:256-8.
Schwesinger WH, Page CP, Sirinek KR. Operations for peptic ulcer disease: Paradigm lost. J Gastrointest Surg.2001;5:438-43.
Ramesh C, Bharti DC, Marwaha, Minhas SS. A comparative study between definitive surgery and simple closure in perforated duodenal ulcer. Ind J Surg. 1996;58(10):275-9.
Seth S, Agrawal KK. A Review of 51 cases of Duodenal perforation in Rohilkhand region. Int J Contemp Med Res. 2016;3(6):1806-8.
Mukherjee A, Naveen D. A clinical Study of Peptic Ulcer Disease and its Complications in Rural population. Sch J App Med Sci. 2014;2(4E):1484- 90.
Banerjee ST. Clinical and endoscopic evaluation of gastroduodenal hemorrhage. Ind J Surg. 1994;92(7):221-2.
Cherukumalli RP, Rao CR. A clinical study of gastric outlet obstruction. Inter Surg J. 2016;4(1):264-9.
Dodiyi-Manuel A, Wichendu PN, Enebeli VC. Presentation and Management of Perforated Peptic Ulcer Disease in a Tertiary Centre In South South Nigeria. J West African College Surgeons. 2015;5:3.
Chalya PL, Mabula JB, Koy M, Mchembe MD, Jaka HM, Kabangila R, et al. Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experience. World J Emerg Surg. 2011 Dec;6(1):31.
Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1:1311-5.
Güzel H, Kahramanca S, Seker D, Ozgehan G, Tunc G, Kucukpinar T, et al. Peptic ulcer complications requiring surgery: what has changed in the last 50 years in Turkey. Turk J Gastroenterol. 2014;25:152-5.
Wilcox CM. Sholek KA, Cotsonis G. Striking prevalence of over the counter NSAID use in patients with upper gastrointestinal hemorrhage. Arch Intern Med. 1994;154:42-6.
Mourougayan V, Smile SR, Sibal RN. Morbidity and mortality of definitive surgical procedure in duodenal ulcer perforation. Ind J Surg, 1994;56(3):102-8.
Clement SH, Cherukumalli RP, Rao CR. A clinical study of gastric outlet obstruction. Int Surg J. 2017;4(1):264-9.
Bloom BS, Fendrick AM, Ramsey SD. Changes in peptic ulcer andgastritis/duodenitis in Great Britain in 1970-85. J Clin Gastroenterol. 1990;12:100-8.
Khairnar MR, Wadgave U, Shimpi PV. Updated BG Prasad socioeconomic classification for 2016. J Indian Assoc Public Health Dent. 2016;14:469-70.