exudates and Stomach-Ulcer

The objective of this study was to compare the outcomes of patients who underwent laparoscopic and open repair of perforated peptic ulcers (PPUs) at our institution.. This is a retrospective review of a prospectively collected database of patients who underwent emergency laparoscopic or open repair for PPU between December 2010 and February 2014.. A total of 131 patients underwent emergency repair for PPU (laparoscopic repair, n=63, 48.1% vs. open repair, n=68, 51.9%). There were no significant differences in baseline characteristics between both groups in terms of age (p=0.434), gender (p=0.305), body mass index (p=0.180), and presence of comorbidities (p=0.214). Both groups were also comparable in their American Society of Anesthesiologists (ASA) scores (p=0.769), Boey scores 0/1 (p=0.311), Mannheim Peritonitis Index > 27 (p=0.528), shock on admission (p<0.99), and the duration of symptoms > 24 hours (p=0.857). There was no significant difference in the operating time between the two groups (p=0.618). Overall, the laparoscopic group had fewer complications compared with the open group (14.3% vs. 36.8%, p=0.005). When reviewing specific complications, only the incidence of surgical site infection was statistically significant (laparoscopic 0.0% vs. open 13.2%, p=0.003). The other parameters were not statistically significant. The laparoscopic group did have a significantly shorter mean postoperative stay (p=0.008) and lower pain scores in the immediate postoperative period (p<0.05). Mortality was similar in both groups (open, 1.6% vs. laparoscopic, 2.9%, p < 0.99).. Laparoscopic repair resulted in reduced wound infection rates, shorter hospitalization, and reduced postoperative pain. Our single institution series and standardized technique demonstrated lower morbidity rates in the laparoscopic group.

Topics: Academic Medical Centers; Adult; Aged; Cohort Studies; Databases, Factual; Emergencies; Female; Follow-Up Studies; Gastrectomy; Humans; Laparoscopy; Laparotomy; Length of Stay; Malaysia; Male; Middle Aged; Minimally Invasive Surgical Procedures; Operative Time; Pain, Postoperative; Peptic Ulcer Perforation; Quality Improvement; Retrospective Studies; Risk Assessment; Stomach Ulcer; Treatment Outcome; Young Adult

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting.. A time trend study of upper gastrointestinal disease and H. pylori infection in three time periods: 1989-1990, 1999-2000 and 2009-2010 spanning a period of 20 years was carried out.. Consecutive first time gastroscopies carried out on patients attending the University of Malaya Medical Center were studied. Diagnoses and H. pylori infection status were carefully recorded.. A steady decline in prevalence of duodenal ulcer (DU) and gastric ulcer (GU) from 21.1% to 9.5% to 5.0% and from 11.9% to 9.4% to 9.9% while an increase in erosive oesophagitis (EO) from 2.0% to 8.4% to 9.5% (chi-square for trend; P < 0.001) for the periods 1989-1990, 1999-200 and 2009-2010 were observed. The overall prevalence of H. pylori had also decreased from 51.7% to 30.3% to 11.1% for the same periods of time. The proportion of H. pylori positive ulcers had also decreased: DU (90.1%-69.8%-28.9%) and GU (86.6-56.8%-18.9%) (P < 0.001). This was observed in Malays, Chinese and Indians but the difference over time was most marked in Malays. There was a steady decline in the proportion of patients with gastric and oesophageal cancers.. Peptic ulcers have declined significantly over a 20-year period together with a decline in H. pylori infection. In contrast, a steady increase in erosive oesophagitis was observed. Gastric and oesophageal squamous cell cancers have declined to low levels.

Topics: Adult; Aged; Asian People; Carcinoma, Squamous Cell; Duodenal Ulcer; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Gastrointestinal Diseases; Helicobacter Infections; Helicobacter pylori; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer; Population Surveillance; Stomach Ulcer; Time Factors

A review of 82 (68 male) Kelantanese patients with non-alcoholic cirrhosis who underwent gastroduodenal endoscopy revealed duodenal and gastric ulcers in 4.9% and 7.3% of patients respectively. Comparing with prevalence rates of peptic ulcer disease reported in the literature, there was no evidence to suggest that duodenal ulcers occur more frequently in patients with non-alcoholic cirrhosis. There is a suggestion, albeit a tenuous one, that non-alcoholic cirrhosis may be associated with gastric ulceration.

Topics: Duodenal Ulcer; Duodenoscopy; Female; Gastroscopy; Humans; Liver Cirrhosis; Malaysia; Male; Stomach Ulcer

The influence of the age of onset of symptoms on various clinical features of peptic ulcer was studied in a personal series of 492 patients (duodenal ulcer 363, gastric ulcer 98, combined gastric and duodenal ulcer 31). Duodenal ulcer patients whose age of onset of symptoms was within the first three decades (n = 166) were more likely to be men (77%) and to have a positive family history of dyspepsia (45%) and a history of haemorrhage (46%) when compared with late onset patients (n = 197, men 57%, positive family history 23%, history of haemorrhage 36%). Early onset duodenal ulcer patients also secreted more gastric acid than late onset patients. In contrast, while early onset gastric ulcer patients were more likely to be men, when compared to late onset patients, the two groups were similar in their family history of dyspepsia, their history of haemorrhage, and their gastric acid output. The age of onset of Malay duodenal ulcer patients (mean (SD) 43.6 (16.0] was higher than those for Chinese patients (33.7 (16.1].

Topics: Adult; Age Factors; China; Duodenal Ulcer; Female; Humans; Malaysia; Male; Peptic Ulcer Hemorrhage; Singapore; Stomach Ulcer

Topics: Adult; Aged; Duodenal Ulcer; Endoscopy; Female; Gastroscopy; Humans; Malaysia; Male; Middle Aged; Stomach Ulcer

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Duodenal Ulcer; Endoscopy; Female; Gastrointestinal Hemorrhage; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer Hemorrhage; Stomach Ulcer

Topics: Adolescent; Adult; Duodenal Ulcer; Ethnicity; Female; Follow-Up Studies; Humans; Malaysia; Male; Middle Aged; Peptic Ulcer Perforation; Pneumoperitoneum; Postoperative Complications; Stomach Neoplasms; Stomach Rupture; Stomach Ulcer