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Cimetidine and perforated peptic ulcer

A J McKay, C S McArdle

    The British Journal of Surgery
    |June 1, 1982
    PubMed
    Summary

    Cimetidine significantly reduced elective peptic ulcer surgery rates by 45%. However, the incidence of perforated peptic ulcers saw only a minor 10% decrease, indicating limited impact on this severe complication.

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    Area of Science:

    • Gastroenterology
    • Pharmacology
    • Surgical Outcomes

    Background:

    • Peptic ulcer disease management has evolved with pharmacologic interventions.
    • Cimetidine, a histamine H2-receptor antagonist, was introduced in 1976.
    • The impact of cimetidine on perforated peptic ulcer incidence remained unclear.

    Purpose of the Study:

    • To evaluate the effect of cimetidine introduction on peptic ulcer surgery rates.
    • To assess the incidence of perforated peptic ulcers before and after cimetidine availability.
    • To analyze patient data for perforation cases occurring during cimetidine therapy.

    Main Methods:

    • A 15-year retrospective review (1966-1980) of peptic ulcer surgery at a district general hospital.
    • Comparison of annual elective operation numbers pre- and post-cimetidine introduction (November 1976).
    • Detailed review of 105 patients treated for peptic ulcer perforation from 1978-1980.

    Main Results:

    • Elective peptic ulcer surgery decreased by 45% (from 91.4 to 50.5 annually) after cimetidine became available.
    • The annual number of perforations decreased by only 10% (from 40.6 to 36.5).
    • Of 64 patients with chronic ulcers experiencing perforation, 16 were current or recent cimetidine users.

    Conclusions:

    • Cimetidine has substantially decreased the need for elective peptic ulcer surgery.
    • There has been no equivalent reduction in the incidence of perforated peptic ulcers.
    • Cimetidine's role in preventing severe ulcer complications like perforation warrants further investigation.

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