FEASIBILITY OF ERAS (ENHANCED RECOVERY AFTER SURGERY) PROTOCOL IN PATIENTS UNDERGOING EMERGENCY REPAIR FOR PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CARE HOSPITAL

Introduction: The surgical treatment of perforated peptic ulcer disease has evolved in parallel to advances in medical treatment of Peptic Ulcer Disease. Objective: To investigate the feasibility of ERAS (Enhanced Recovery after Surgery) Pathways in patients undergoing emergency repair for Perforated peptic ulcer disease. Materials and methods: Institutional based prospective analytical study. Indoor patients in Dept. of General Surgery in Medical College and Hospital Kolkata. January 2019 to June 2020. Study was conducted for 18 months.14 months was provided for data collection. Next 2 months for statistical analysis and another 2 months for thesis writing and submission. Conclusion: ERAS pathway (with some modications) seems to be safe and feasible in a highly selected subset of patients undergoing emergency Omental grahams patch repair of Perforated Peptic Ulcer Disease

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Association of Helicobacter Pylori with Peptic Ulcer Perforation

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24960 ◽

2019 ◽

Vol 2 (1) ◽

pp. 4-10

Author(s):

Sunit Agrawal ◽

D Thakur ◽

P Kafle ◽

A Koirala ◽

R K Sanjana ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Perforated Peptic Ulcer ◽

Patch Repair ◽

Peptic Ulcer Perforation ◽

Ulcer Disease ◽

Ulcer Perforation ◽

H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

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Perforated Peptic Ulcer Disease: Factors Predicting The Mortality And Morbidity In A Tertiary Care Centre In Southern India.

The Internet Journal of Surgery ◽

10.5580/170a ◽

2011 ◽

Vol 27 (2) ◽

Cited By ~ 1

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Tertiary Care ◽

Perforated Peptic Ulcer ◽

Southern India ◽

Care Centre ◽

Tertiary Care Centre ◽

Mortality And Morbidity ◽

Ulcer Disease

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“PREVALENCE OF H.PYLORI INFECTION IN PEPTIC ULCER DISEASE PATIENTS IN A TERTIARY CARE HOSPITAL, KURNOOL, ANDHRA PRADESH.”

10.36106/ijsr/7029209 ◽

2021 ◽

pp. 26-29

Author(s):

G.Lakshmi Kavya ◽

B Shankar Sharma ◽

P Swarupa Rani

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Descriptive Analysis ◽

Tertiary Care ◽

Rapid Urease Test ◽

Care Hospital ◽

Ulcer Disease ◽

Modern Times ◽

Urease Test

BACKGROUND: With the outstanding & revolutionary discovery of Helicobacter Pylori(H.Pylori) organism as a causative agent in Peptic Ulcer Disease (PUD), Gastric carcinoma and Malt Lymphoma, there has been a lot of interest generated about H.Pylori in modern times. The role of NonSteroidal Anti-Inammatory Drugs(NSAIDs) in the causation of Gastric Ulcer (GU) & Duodenal Ulcer (DU) is also an important point of study now-a-days. AIM & OBJECTIVES: To assess the prevalence of H.Pylori in patients of PUD diagnosed with Upper Gastro-Intestinal Endoscopic (UGIE) examination. MATERIALS & METHODS: Total 100 patients of the study underwent UGIE examination. Rapid Urease Test of gastric biopsy specimens of all patientswas done forthepresenceofH.Pylori. RESULTS:Out of 100PUDpatients, 74weremales&26were females.Out of 54H.Pylori associatedPUDpatients, 41(76%)weremales and 13(24%) were females. About 47% patients had GU, 43% had DU and 10% had both GU & DU. About 34(79%) DU patients were associated with H.Pylori infection. Out of 47 GU patients, 11(23%) are associated with NSAID usage, 7(15%) are associated with H.Pylori & other 53% had associated comorbidities like HTN, DM, CAD and CLD. Descriptive analysis in percentage was done by using MS Excel. CONCLUSION:Thendings ofthisstudy revealthatH.Pyloriinfection ismore common inmalesthan females.High prevalence ofH.Pyloriinfection isseeninDUpatients.NSAIDabusewas highinGUpatients.Thisstudyhighlightsthe signicanceofH.Pylori&NSAIDusage inPUDpatients.

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High prevalence of duodenal ulcer in a tertiary care hospital in the city of São Paulo, SP, Brazil

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000300003 ◽

2011 ◽

Vol 48 (3) ◽

pp. 171-174 ◽

Cited By ~ 9

Author(s):

Sergio B. Marques ◽

Rejane Mattar ◽

Everson L. A. Artifon ◽

Paulo Sakai ◽

Flair José Carrilho

Keyword(s):

Duodenal Ulcer ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Male Gender ◽

Care Hospital ◽

Ulcer Disease ◽

High Prevalence ◽

H Pylori

CONTEXT: In spite of Helicobacter pylori infection being the etiological cause of peptic ulcer and its high prevalence in Brazil, the prevalence of peptic ulcer disease has been poorly studied. OBJECTIVES: To verify the peptic ulcer disease prevalence in patients of a tertiary care hospital. METHODS: Diagnostic findings from 1,478 consecutive endoscopies were correlated with the urease test results for H. pylori infection diagnosis and demographic data in a total of 3,779 endoscopies performed in 2005. The mean age of the patients was 51.14 ± 16.46, being 613 (41.5%) men. RESULTS: Peptic ulcer was diagnosed in 494 (33.4%) patients with a mean age of 54.86 ± 14.53, 205 (52%) were men, being 391 (26.5%) duodenal ulcer and 103 (7%) gastric ulcer. Normal endoscopy was found in 272 (18.4%) patients with a mean age of 38.4 ± 15.22, being 49 (18%) men. The comparison of peptic ulcer group with the patients that had normal endoscopy revealed that H. pylori infection [P = 0.005; OR = 1.70; 95% CI = 1.17-2.47][ign], male gender [P<0.0001; OR = 5.53; 95%CI = 3.67-8.34][ign] and older age [P<0.0001; OR = 1.08; 95%CI = 1.06-1.09] increased the risk of peptic ulcers. The overall H. pylori prevalence was 53% (786). CONCLUSIONS: Prevalence of duodenal ulcer is high in a Brazilian population that had H. pylori infection associated with older age and male gender as important determinants to gastrointestinal diseases outcome. Future prospective studies should confirm these findings.

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