How Is H. pylori Changing the Life of the Surgeon with Respect to Peptic Ulcer Surgery?
Although H2-receptor antagonists and PPIs have had a major impact on surgical indications and decision-making in gastroduodenal disease, H. pylori has further changed gastroduodenal surgery. Nowadays, surgery for uncomplicated peptic ulcer disease is extremely rare [54], but operations for complications of peptic ulcer disease such as bleeding, perforation and gastric outlet obstruction are still frequently performed by gastrointestinal surgeons. This is in part due to the continuous use of NSAIDs in the patient population at risk. While there is a clear association between consumption of NSAIDs and peptic ulcers, is it currently not known whether the ratio of NSAID-induced emergency ulcer operations has changed with the introduction of H. pylori eradication. However, it is clear that NSAID use represent a major risk factor for complicated peptic ulcer disease, responsible for the majority of emergency ulcer operations in some series [55, 56, 57]. In conclusion, a combination of H2-rec
