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Article: The role of early endoscopic follow up after simple closure of perforated duodenal ulcer: A prospective study

TitleThe role of early endoscopic follow up after simple closure of perforated duodenal ulcer: A prospective study
Authors
KeywordsHelicobacter Pylori
Peptic Ulcer
Perforation
Issue Date2002
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASH
Citation
Annals Of The College Of Surgeons Of Hong Kong, 2002, v. 6 n. 3, p. 71-76 How to Cite?
AbstractObjective: Eradication of Helicobacter pylori is effective in preventing ulcer relapse after simple repair of perforated duodenal ulcers. However, when and how the H. pylori status should be determined remains unclear. The study investigated the role of early endoscopic follow up in managing patients with simple omentopexy for duodenal ulcer perforation. Patients and Method: Patients below the age of 75 years who had simple repair of perforated duodenal ulcer were recruited. They were given a 4-week course of H 2 receptor antagonist upon discharge and advised to return for a follow-up endoscopy at 8 weeks after operation. During endoscopic examination, ulcer healing and other gastroduodenal pathology were noted. Random biopsies were taken from the antrum and body of the stomach for determination of H. pylori infection. Results: In a 30-month period, 112 patients were admitted with perforated duodenal ulcers. The perforation was repaired by either laparoscopic (n = 41) or open method (n = 71). Eleven patients died during hospitalization. Of the 101 patients who recovered, 16 were lost to follow up. Nine patients were considered unfit for endoscopy as a result of medical comorbidities. Among the 76 patients who attended the follow-up endoscopy, 47 were shown to have H. pylori infection (61.8%). Active duodenal ulcers were found in 15 patients, significant erosions in five patients and severe duodenitis in seven patients. Patients infected by H. pylori had a significantly higher proportion of persistent duodenal pathology compared with the uninfected patients (23/47 vs 4/29; P= 0.003). Multivariate analysis revealed that smoking and H. pylori infection were the two independent factors predicting persistent duodenal lesions. Conclusion: Patients treated with simple-closure for duodenal ulcer perforation are recommended to have their H. pylori status determined by early follow-up endoscopy, and an eradication regimen should be prescribed to those who are positive for the infection.
Persistent Identifierhttp://hdl.handle.net/10722/162626
ISSN
References

 

DC FieldValueLanguage
dc.contributor.authorNg, EKWen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorTo, KFen_US
dc.contributor.authorWong, SKHen_US
dc.contributor.authorLai, PBSen_US
dc.contributor.authorLau, WYen_US
dc.contributor.authorSung, JJYen_US
dc.contributor.authorChung, SSCen_US
dc.date.accessioned2012-09-05T05:21:49Z-
dc.date.available2012-09-05T05:21:49Z-
dc.date.issued2002en_US
dc.identifier.citationAnnals Of The College Of Surgeons Of Hong Kong, 2002, v. 6 n. 3, p. 71-76en_US
dc.identifier.issn1028-4001en_US
dc.identifier.urihttp://hdl.handle.net/10722/162626-
dc.description.abstractObjective: Eradication of Helicobacter pylori is effective in preventing ulcer relapse after simple repair of perforated duodenal ulcers. However, when and how the H. pylori status should be determined remains unclear. The study investigated the role of early endoscopic follow up in managing patients with simple omentopexy for duodenal ulcer perforation. Patients and Method: Patients below the age of 75 years who had simple repair of perforated duodenal ulcer were recruited. They were given a 4-week course of H 2 receptor antagonist upon discharge and advised to return for a follow-up endoscopy at 8 weeks after operation. During endoscopic examination, ulcer healing and other gastroduodenal pathology were noted. Random biopsies were taken from the antrum and body of the stomach for determination of H. pylori infection. Results: In a 30-month period, 112 patients were admitted with perforated duodenal ulcers. The perforation was repaired by either laparoscopic (n = 41) or open method (n = 71). Eleven patients died during hospitalization. Of the 101 patients who recovered, 16 were lost to follow up. Nine patients were considered unfit for endoscopy as a result of medical comorbidities. Among the 76 patients who attended the follow-up endoscopy, 47 were shown to have H. pylori infection (61.8%). Active duodenal ulcers were found in 15 patients, significant erosions in five patients and severe duodenitis in seven patients. Patients infected by H. pylori had a significantly higher proportion of persistent duodenal pathology compared with the uninfected patients (23/47 vs 4/29; P= 0.003). Multivariate analysis revealed that smoking and H. pylori infection were the two independent factors predicting persistent duodenal lesions. Conclusion: Patients treated with simple-closure for duodenal ulcer perforation are recommended to have their H. pylori status determined by early follow-up endoscopy, and an eradication regimen should be prescribed to those who are positive for the infection.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASHen_US
dc.relation.ispartofAnnals of the College of Surgeons of Hong Kongen_US
dc.subjectHelicobacter Pylorien_US
dc.subjectPeptic Ulceren_US
dc.subjectPerforationen_US
dc.titleThe role of early endoscopic follow up after simple closure of perforated duodenal ulcer: A prospective studyen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1442-2034.2002.00136.xen_US
dc.identifier.scopuseid_2-s2.0-0036696880en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036696880&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume6en_US
dc.identifier.issue3en_US
dc.identifier.spage71en_US
dc.identifier.epage76en_US
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridNg, EKW=7201647539en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridTo, KF=24336843300en_US
dc.identifier.scopusauthoridWong, SKH=24345849900en_US
dc.identifier.scopusauthoridLai, PBS=7202946421en_US
dc.identifier.scopusauthoridLau, WY=7402933199en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridChung, SSC=35314588700en_US

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