TỶ LỆ NHIỄM HELICOBACTER PYLORI VÀ KẾT QUẢ PHẪU THUẬT NỘI SOI KHÂU LỖ THỦNG Ổ LOÉT DẠ DÀY-TÁ TRÀNG Ở NGƯỜI CAO TUỔI TẠI ĐỒNG THÁP

Abstract

Background: Perforated gastric and duodenal ulcers are dangerous surgical emergencies, especially in elderly patients. However, evidence regarding the effectiveness of laparoscopic repair for perforated gastric and duodenal ulcers and the prevalence of Helicobacter pylori infection at healthcare facilities located far from major centers remains limited. Objectives: To describe the clinical and paraclinical characteristics, the prevalence of Helicobacter pylori infection, the outcomes of laparoscopic repair for perforated gastric and duodenal ulcers, and the results of Helicobacter pylori eradication treatment in elderly patients in Dong Thap. Materials and methods: A prospective descriptive study was conducted on 36 patients aged ≥ 60 years with perforated gastric and duodenal ulcers who underwent laparoscopic perforation repair with intraoperative rapid urease testing at Dong Thap General Hospital from March 2025 to December 2025. Results: The mean age was 71.3 ± 8.16 years; males accounted for 69.4%, and 75% had associated comorbidities. The median onset time was 7 hours; 58.3% presented with sudden abdominal pain, and 77.8% had abdominal rigidity. The median white blood cell count was 12,245/mm³; chest/abdominal X-ray detected subdiaphragmatic free air in 86.1% of cases, while ultrasound identified free intraperitoneal air in 77.8%. Gastric perforation accounted for 77.8% of cases. The rapid urease test was positive in 58.3% of patients, and the Helicobacter pylori eradication success rate was 85.7%. Postoperative complications occurred in 27.8% of cases, and the mortality rate was 5.6%. Associated factors included advanced age, which increased postoperative complications (p = 0.032), and the Boey score, which was associated with mortality (p = 0.025). Conclusion: Laparoscopic surgery is a safe and effective treatment for perforated gastric and duodenal ulcers in elderly patients. The high rates of Helicobacter pylori infection and successful eradication support the role of bismuth-based quadruple therapy. Age, Boey score, and ASA classification are valuable factors for prognosis and clinical management.