Surgical management of perforated peptic ulcer disease

Background Surgery for perforated peptic ulcer disease is one of the most common emergency procedures carried out in the western world. The role of postoperative empiric Helicobacter Pylori eradication therapy is controversial.Methods The clinical, operative and postoperative surveillance details of 84 consecutive patients who underwent surgery for perforated peptic ulcer were reviewed.Results All patients underwent omentopexy simple closure followed by proton pump therapy. Patients were followed-up for an average Of 44 19 months. Females were older than male patients (59 + - 20 vs. 46 + - 17 years; P0.05), presented with symptoms of a longer duration (17.9 + - 16 vs. 8.9 + - 9 hours; P=0.045) and had a higher mortality rate (18% vs 3%; P0.05). Seventy-nine per cent of patients received postoperative empiric Helicobacter Pylori eradication therapyConclusions Surgery for perforated peptic ulcer is associated with a significant periciperative mortality rate. Elderly female patients are particularly at risk.