Work

Impact of smoking and age on long-term recurrence after laparoscopic primary closure for duodenal ulcer perforation: a 5-year observational study

Year: 2025

Type: article

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.

Source: Annals of Surgical Treatment and Research

DOI: 10.4174/astr.2025.109.2.98