Impact of smoking and age on long-term recurrence after laparoscopic primary closure for duodenal ulcer perforation: a 5-year observational study
10.4174/astr.2025.109.2.98
- Author:
Tae-Han KIM
;
Sang-Ho JEONG
;
Young-Joon LEE
;
Dong-Hwan KIM
;
Han-Gil KIM
;
Jae-Myung KIM
;
Jin-Kyu CHO
;
Seung-Jin KWAG
;
Ju-Yeon KIM
;
Young-Tae JU
;
Chi-Young JEONG
;
Ji-Ho PARK
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2025;109(2):98-104
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study investigates risk factors for recurrence in patients who underwent laparoscopic primary closure (PC) for pyloroduodenal ulcer perforation (PUP).
Methods:We retrospectively analyzed data from patients who underwent laparoscopic PC with or without highly selective vagotomy (HSV) for PUP at a tertiary hospital from 2010 to 2019. Demographics, surgical outcomes, proton pump inhibitor (PPI) use, Helicobacter pylori status, and endoscopic findings were reviewed. Long-term (5 years) endoscopic and clinical outcomes regarding ulcer and perforation recurrence, were collected.
Results:A total of 139 patients were included in the analysis. Of these, 109 (78.4%) were male, and 76 (54.7%) were current smokers. Ninety-five patients (68.3%) underwent PC only, while 44 (31.7%) received PC + HSV. During the follow-up period, ulcer recurrence was observed in 19 patients (13.7%) and perforation recurrence in 9 (6.5%). In Cox proportional analysis for ulcer recurrence, smoking (hazard ratio [HR], 6.476; 95% confidence interval [CI], 1.834–22.873; P = 0.004) and older age (HR, 1.049; 95% CI, 1.012–1.088; P = 0.009) were identified as significant factors. For peptic ulcer perforation recurrence, smoking (HR, 19.129; 95% CI, 2.048–178.702; P = 0.010) and older age (HR, 1.062; 95% CI, 1.009–1.118; P = 0.021) were significant. No significant associations were found between sex, duration of PPI therapy, H. pylori eradication success, or surgery type and the risk of either ulcer or perforation recurrence.
Conclusion:Smoking and age are important factors for recurrence following laparoscopic PC for PUP. These findings emphasize the need for smoking cessation and close postoperative monitoring.
