Study supports the current practice of post-surgery H. pylori eradication in patients with perforated peptic ulcers.
The authors of “Eradication of Helicobacter pylori for Prevention of Ulcer Recurrence after Simple Closure of Perforated Peptic Ulcer: A Meta-Analysis of Randomized Controlled Trials,” published in the Journal of Surgical Research, note that although eradication of H. pylori is part of the standard therapy for peptic ulcer, the role of H. pylori eradication in perforation of peptic ulcers “remains controversial,” in part because it remains unclear whether “eradication of the bacterium confers prolonged ulcer remission after simple repair of perforated peptic ulcer.”
To evaluate the effects of H. pylori eradication on prevention of ulcer recurrence after simple closure of perforated peptic ulcers, the authors analyzed data from five randomized controlled trials involving 401 patients with peptic ulcers, focusing on the incidence of postoperative ulcers and the rate of H. pylori elimination.
They reported that “a high prevalence of H. pylori infection occurred in patients with perforated peptic ulcers,” and that eradication of H. pylori “significantly reduced the incidence of ulcer recurrence” at eight weeks and one year post-operation. They also found that the rate of H. pylori eradication was “significantly higher in the treatment group than in the nontreatment group.”
These results support continuing the practice of providing eradication therapy to patients with H. pylori infection after simple closure of perforated gastroduodenal ulcers.