Effectiveness of Early Performed Postoperative Endoscopy in Peptic Ulcus Perforation

This study aims to evaluate the retrospective results of peptic ulcer perforation (PUP) treatment and assess the effectiveness and safety of early postoperative endoscopy.

Patients who underwent PUP surgery at Mersin University Hospital between 2010 and 2024 were analyzed. Demographic data, treatment methods, clinical outcomes, and early postoperative (6-8 wk) endoscopy results were evaluated for healing, complications, and recurrence. The correlation between treatment approach and clinical outcomes was statistically analyzed.

A total of 176 patients underwent PUP surgery. A total of 70.4% (124) of the citizens are male. A total of 29.6% (52) of the patients are female. The average age was 61.2 years. Surgical interventions were performed by open surgery in 77.3% (136) and by laparoscopic method in 22.7% (40). Omental patching was performed in 93.8% (165) of the patients, simple closure was performed in 4.5% (8), and gastric resection was performed in 1.7% (3 patients). Peroperative biopsy was taken from all patients. In the biopsy results, Helicobacter pylori -positive ulcer was detected in 88.3% (156) of the patients, chronic inflammation was detected in 10.2% (18), and malignancy was detected in 1.1% (2). All patients were recommended a complete gastrointestinal endoscopy within 6 to 8 weeks after surgery. However, endoscopy was not performed in 54.6% of the patients (96 patients). In endoscopic evaluation, 15.6% (15) ulcers, 81.3% (78) normal findings, and 3.1% (3) malignancies were detected.

PUP can be effectively treated with laparatomy/laparoscopy, and omental patch repairment. Postoperative upper gastrointestinal endoscopy should be performed with an initial biopsy to avoid missing an underlying malignancy.