Abstract
The advent of more effective and tolerable drugs (H2 antagonists, proton pump inhibitors, antibiotics for Helicobacter pylori, HP, infection) in the treatment of the peptic ulcer has brought about a radical change in the surgical approach to ulcer disease. In fact we can observe an increasing election for minor surgery and a progressive increase in the treatment in emergency for perforating complications. This figure is likely to be attributed on the one hand to the number of surgical indications and on the other to the increasingly widespread use of nonsteroid anti-inflammatory drugs (NSAIDs), especially in the elderly, where surgery has progressively increased in recent years. The peptic ulcer remains the most common cause of gastroduodenal perforation with an incidence ranging from 2% to 10% of the patients with a peptic ulcer [1] and, consequently, the treatment of a perforated peptic ulcer (PPU) remains today the most frequent indication for gastric emergency surgery [2]. The progress of medical treatment, and in particular the radical treatment of HP, has gradually decreased the use of major gastric surgery. Resective treatment (so-called acid-reduction treatment) has decreased as have recurrences of ulcerative disease, and consequently the need for re operation. Considering these conditions the mini-invasive technique, as in other fields, has been adopted to treat a perforated peptic ulcer.KeywordsFibrin GlueIntraabdominal AbscessPerforated Peptic UlcerOmental FlapTraditional SurgeryThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Published Version
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