Simple closure of chronic duodenal ulcer perforation in the era of Helicobacter pylori: an old procedure, today's solution.

BACKGROUND/AIMS: To evaluate the risk of recurrence in our patients with chronic duodenal ulcer perforation, who underwent a simple closure and postoperative Helicobacter pylori eradication therapy.

METHODOLOGY: Within 4.5 years (3/1996 to 7/2000), 21 patients with chronic duodenal ulcer perforation, were operated in our hospital. All of them underwent simple closure with omental patch repair plus Helicobacter pylori eradication with omeprazole, clarithromycin and amoxycillin for two weeks. On December 2000, in 14 (66.6%) of these patients, urea breath test for Helicobacter pylori was performed, followed by endoscopy.

RESULTS: The mean age of our 14 patients is 55 years. The urea breath test was positive for Helicobacter pylori in 3 (21.4%) patients. Two of them had endoscopically gastritis, confirmed by pathological examination. None of our patients had ulcer relapse. The three patients with positive urea breath test received another course of the same eradication therapy.

CONCLUSIONS: Simple closure of perforated chronic duodenal ulcer in combination with postoperative Helicobacter pylori eradication, seems to be an accepted treatment, so the immediate acid-reduction surgery (vagotomy) in the contaminated environment caused by perforation, is probably unnecessary.