J.Jpn. Surg. Soc.. 87(9): 1140-1143, 1986

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Report on the annual meeting

CHANGES IN NATURAL HISTORY AND PATHOPHYSIOLOGY OF DUODENAL ULCER DISEASE UNDER THE MODERN CONSERVATIVE TREATMENTS WITH SPECIAL REFERENCE TO THE SURGICAL TREATMENTS

After the introduction of H₂-receptor antagonists (H₂-RAs) into the treatment of peptic ulcer disease, more than 80－90% of the patients who have required surgical treatments became of patients with ulcer complications such as perforation, bleeding or stenosis. Some of them were of “too late” stage from the stand point of the “adequate” treatment of the disease.
The absolute number of the surgical patients with the ulcer complications were not changed, compared with the numbers before “the H₂-RAs era”.
Consequently, the ratio of emergency operations were increasing with “life-saving operations”, even if they were often not satisfactorily adequate for the treatment of the peptic ulcer disease itself.
Gastrin responses to the provocation tests in duodenal ulcer patients with previous H₂-RA treatment were significantly increased compared with non-treated patients.
Earlier surgical interventions are now recommended in the patients with；1) poor compliances to the medications. 2) requiring long term maintenance treatment with H₂-RAs, to minimize occurrence of unknown side effects and known unfavorable effect on antral G-cells.

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