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Treatments of peptic ulcer diseaseIsabelle van OudheusdenSCI232 Functional anatomyProfessor Rijkers

Highly selective vagotomy

Pharmaceutical therapyHistamine H2 receptors / proton pump inhibitors:66% healing rate

Helico pylori (H.pylori)80 95% of patients

Similar healing ratesCost-efficiency

Surgical interventionNo elective surgery

Recurrent ulcersPossible complications:BleedingPerforationObstruction

Perforation10-15% of PUD patients2/3 of surgical interventions

Surgery:Simple closure/Grahams patch (90%)Gastric resection (10%)

Note: common cause of peritonitis

Bleeding15 to 20% of PUD patients1/3 of surgical interventions

Endoscopic treatmentLigationPlacement of hemoclips

After 2 attempts:Surgical oversewingEmbolization

Gastric outlet obstruction1-2% of PUD patients

Endoscopic dilation

Surgery:VagotomyPyloroplastyAntrectomyGastroenterostomy