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Postoperative anti-H. pylori therapy after laparoscopic repair for acute gastric ulcer perforation in elderly patientsLaparoscopic Repair Plus Meds Cuts Complications For Elderly

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Key Takeaway
Consider that postoperative anti-H. pylori therapy may lower complications after laparoscopic repair for gastric ulcer perforation in elderly patients.

This retrospective cohort study included 92 elderly patients with acute gastric ulcer perforation managed in a hospital setting. The intervention was laparoscopic gastric perforation repair followed by postoperative quadruple anti-Helicobacter pylori therapy, compared to laparoscopic repair alone.

The combination group showed a mean IL-6 level of 11.89 ± 1.36 pg/mL versus 16.23 ± 1.78 pg/mL in the control group (mean difference: -4.34, 95% CI: 5.00 to -3.69, p < 0.01). The overall complication rate during hospitalization was 4.35% (2/46) in the combination group versus 17.39% (8/46) in the control group (odds ratio: 0.216, 95% CI: 0.043–1.082, P = 0.044).

At 6-month follow-up, ulcer recurrence was 4.65% versus 17.07% (p < 0.05), readmission was 6.98% versus 19.51% (p < 0.05), and overall unfavorable outcomes were 9.30% versus 26.83% (p < 0.05). Safety data showed a lower overall complication rate with the combination therapy.

Key limitations include the retrospective design and the need for validation through larger prospective randomized trials. The practice relevance is that this protocol provides a preliminary basis for safety in elderly patients, but findings are not definitive proof.

Laparoscopic Repair Plus Meds Cuts Complications For Elderly

Imagine an elderly person waking up after stomach surgery. They feel better than expected. Their pain is lower. Their body fights infection with ease. This new approach changes the story for older patients.

Old stomach ulcers can tear through the wall. This creates a hole in the belly. It is a serious emergency. Many older adults face this problem. Their bodies heal slower than younger ones.

Doctors usually fix the hole with surgery alone. This works but has limits. Some patients still get infections. Others suffer from high fever. The stomach does not move food well.

But here is the twist. A new method adds medicine to the mix. Doctors use a four-drug plan to kill bacteria. This plan targets the germ that causes ulcers. It works alongside the surgery.

Think of the stomach like a factory. The bacteria are workers causing trouble. The surgery fixes the broken machine. The medicine stops the bad workers. This stops the factory from shutting down.

The study looked at 92 older patients. They split them into two groups. One group got surgery only. The other group got surgery plus the four-drug plan. Doctors tracked their health for six months.

The results were clear and strong. The group with medicine had lower inflammation. Their blood markers showed less stress. They also had better stomach movement.

The complication rate dropped significantly. Only two patients in the medicine group had issues. Eight patients in the surgery-only group had problems. That is a big difference for families.

This doesn't mean this treatment is available yet.

Experts say this is a safe step forward. It fits with current medical knowledge. The four-drug plan is standard for ulcers. Using it here makes sense.

For patients, this means a smoother recovery. They can go home sooner. They face fewer hospital visits. The risk of the ulcer coming back drops too.

However, there are limits to this study. It looked at only 92 people. That is a small number. The hospital was in one place. Other hospitals may see different results.

More research is needed next. Large trials will test this method. They will check if it works everywhere. This will help doctors decide who gets the treatment.

The future looks bright for older patients. They deserve better care options. This new plan offers hope. It reduces pain and risk. Families can feel more confident.

Larger trials will confirm these findings soon. Doctors will share the results widely. Patients can talk to their care team. They can ask about the four-drug plan. It may be an option for them.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundTo assess the clinical efficacy of laparoscopic gastric perforation repair combined with quadruple therapy for treating acute gastric ulcer perforation in the elderly.MethodClinical data of 92 elderly patients with acute gastric ulcer perforation admitted to our hospital from January 2019 to May 2023 were retrospectively collected. According to the treatment they received, patients were divided into a combination group and a control group, with 46 patients in each group. The control group underwent laparoscopic gastric perforation repair alone, whereas the combination group underwent laparoscopic gastric perforation repair followed by postoperative quadruple anti-Helicobacter pylori therapy. Serum inflammatory factors, gastric electrical parameters, serum motilin and gastrin levels, postoperative conditions, and adverse reactions during treatment were compared between the two groups before and after treatment. In addition, patients were followed up for 6 months after discharge, and long-term outcomes including ulcer recurrence, readmission, reoperation, and all-cause mortality were recorded.ResultsBefore treatment, IL-6, TNF-α, and hs-CRP levels were similar in both groups. Post-treatment, IL-6 levels in the combination group decreased to 11.89 ± 1.36 pg/mL compared to 16.23 ± 1.78 pg/mL in the control group (t = 13.14, p < 0.01); the mean difference was −4.34 (95% CI: 5.00 to −3.69), indicating a robust systemic anti-inflammatory effect. Gastric electrical parameters and serum gastrin and motilin levels increased in both groups, with better results in the combination group (p < 0.05). The overall complication rate during hospitalization was 4.35% (2/46) in the combination group versus 17.39% (8/46) in the control group (χ2 = 4.039, P = 0.044), with an odds ratio (OR) of 0.216 (95% CI: 0.043–1.082). At the 6-month follow-up, 43/46 patients in the combination group and 41/46 patients in the control group were successfully followed. The ulcer recurrence rate was 4.65% (2/43) in the combination group and 17.07% (7/41) in the control group; the readmission rate was 6.98% (3/43) and 19.51% (8/41), respectively; and the overall unfavorable follow-up outcome rate was 9.30% (4/43) and 26.83% (11/41), respectively (p < 0.05 for all).ConclusionThe results suggest that laparoscopic repair combined with quadruple therapy may effectively reduce inflammatory responses, improve gastrointestinal function, lower the incidence of early postoperative complications, and improve 6-month follow-up outcomes in elderly patients with acute gastric ulcer perforation. These findings provide a preliminary basis for the safety of this protocol in elderly patients, although validation through larger prospective randomized trials is required.
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