Systematic review and meta-analysis: Helicobacter pylori eradication therapy after simple closure of perforated duodenal ulcer

Tomtitchong, Prakitpunthu, Siribumrungwong, Boonying, Vilaichone, Ratha-Korn, Kasetsuwan, Petch, Matsukura, Norio and Chaiyakunapruk, Nathorn (2012) Systematic review and meta-analysis: Helicobacter pylori eradication therapy after simple closure of perforated duodenal ulcer. Helicobacter, 17 2: 148-152. doi:10.1111/j.1523-5378.2011.00928.x


Author Tomtitchong, Prakitpunthu
Siribumrungwong, Boonying
Vilaichone, Ratha-Korn
Kasetsuwan, Petch
Matsukura, Norio
Chaiyakunapruk, Nathorn
Title Systematic review and meta-analysis: Helicobacter pylori eradication therapy after simple closure of perforated duodenal ulcer
Formatted title
Systematic review and meta-analysis: Helicobacter pylori eradication therapy after simple closure of perforated duodenal ulcer
Journal name Helicobacter   Check publisher's open access policy
ISSN 1083-4389
1523-5378
Publication date 2012-04
Sub-type Article (original research)
DOI 10.1111/j.1523-5378.2011.00928.x
Volume 17
Issue 2
Start page 148
End page 152
Total pages 5
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
Background:  The most common complications of peptic ulcer are bleeding and perforation. In many regions, definitive acid reduction surgery has given way to simple closure and Helicobacter pylori eradication.

Aim:  To perform a systematic review and meta-analysis to ask whether this change in practice is in fact justified.

Materials and Methods:
  A search on the Cochrane Controlled Trials Register, Medline, and Embase was made for controlled trials of duodenal ulcer perforation patients using simple closure method plus postoperative H. pylori eradication therapy versus simple closure plus antisecretory non-eradication therapy. The long-term results for prevention of ulcer recurrence were compared.

Results: 
The pooled incidence of 1-year ulcer recurrence in H. pylori eradication group was 5.2% [95% confidence interval (CI) of 0.7 and 9.7], which is significantly lower than that of the control group (35.2%) with 95% CI of 0.25 and 0.45. The pooled relative risk was 0.15 with 95% CI of 0.06 and 0.37.

Conclusions: 
Helicobacter pylori eradication after simple closure of duodenal ulcer perforation gives better result than the operation plus antisecretory non-eradication therapy for prevention of ulcer recurrence. All duodenal ulcer perforation patients should be tested for H. pylori infection, and eradication therapy is required in all infected patients.
Keyword Helicobacter pylori
Meta-analysis
Perforated duodenal ulcer
Simple closure
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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