Peptic ulcer complications, surgical treatment, comparison of open and laparoscopic approach, minimally invasive approach recommendations

INTRODUCTION: The treatment of peptic ulcer disease (PUD) has undergone significant changes over time. Elective surgical treatment of PUD has been replaced by medical treatment. Surgical treatment of PUD is limited to ulcer complications and disease resistant to medical treatment. The main issue to be decided during surgery is whether to add a definitive anti-ulcer surgery in addition to treating the immediate ulcer complication. Our aim in this study is to share the results of gastric ulcer complications treated with open and laparoscopic methods in our clinic and the postoperative endoscopy results of these patients.
METHODS: Patients who underwent open or closed ulcer surgery due to ulcer complications in our General Surgery clinic between 2014 and 2023 were retrospectively scanned from the hospital information system. In addition to demographic data such as patients’ age and gender, the surgical method applied, duration of hospital stays, and endoscopy findings in patients who underwent endoscopy during the postoperative period were recorded. The results were examined.
RESULTS: A total of 194 patients were included in the study. Of the patients, 178 (91.8%) were male and 16 (8.2%) were female. The patients were between the ages of 18 and 93, with a mean age of 45.4±20.4 years. Endoscopy was performed on 44 patients after surgery. The mean duration between surgery and endoscopy was 504±586 days. Of the surgeries, 145 (74.7%) were open and 49 (25.3%) were laparoscopic. Gastritis and erosion were the most frequently observed findings in postoperative endoscopies, with bleeding in 2 patients, stenosis in 4 patients, and recurrent ulcers in 16 patients.
DISCUSSION AND CONCLUSION: Surgical treatment of PUD can be performed using open and laparoscopic methods. Despite the advances in medical treatments, ulcer complications are still observed after surgery. The dilemma of whether to add anti-ulcer treatment to emergency surgeries continues, and more comprehensive studies are needed in this regard.