Abstract

AIM: To determine whether eradication of H. pylori could reduce the risk of ulcer recurrence after simple closure of perforated peptic ulcer. We sought that simple closure has been associated with high ulcer recurrence rates of 30% to 80%..Recently, a high prevalence of H. pylori infection has been re porte d in patients with perforations of peptic ulcer. It is unclear whether eradication of the bacterium confers prolonged ulcer remission after simple repair and hence obviates the need for an immediate defınitive operation. MATERIAL AND METHOD: From January 2002 to December 2003, 95 patients were confırmed to have peptic ulcer perforation by laparotomy and 78 patients were eligible for the study. 66 (84.6%) patients were shown to be infected by H. Pylori. H. Pylori positive patients vvere rarıdomized into two groups as group I (n=36, Eradication group), and Group II (n=32, Control goup). For cases in eradication group, triple anti-helicobacter therapy (KLAC1D 4x2.50 mg+ AMOXICILLINE 4x500 mg) were performed while only 4 -week PPİ Therapy (Lansoprol, 2 30 m g/gün) for control goup. In Follow-up periods, endoscopic controls was performed 2 month and 1 year after hospital discharge for surveillance of ulcer healing and ulcer recurrence status. FINDINGS: 33(97.0%) patients in the eradication group and 29(91,4%) patients in control group had ulcer healed at 2 month). Initial ulcer healing rates were similar in the two groups (p=l.00). Afıer 1 year, ulcerre 1 apse was observed in 4(11.7%) patients in eradication group while 16(50.0%) patients in control. Group. Difference between two groups was statistically significant (p=0.002). CONCLUSION: Eradication of Fî. Pylori prevents ulcer recurrence in patients with H. Pylori- associated perforated peptic ulcers, and this, immediate acid-reduction surgery in the presence of generalized peritonitis is unnecessary.