Surgical implications of Helicobacter pylori infection

Helicobacter pylori infection is the most common cause of peptic ulcer dise ase and is an etiologic factor in the development of gastric malignancies. Eradication of H. pylori heals most uncomplicated peptic ulcers, as well as preventing their relapse. In addition, H. pylori therapy has recently been used as a first line treatment for most low grade MALT lymphomas. Despite its efficacy, a small percentage of patients with peptic ulcer disease will require operative intervention and the indications for surgical interventi on for the patient with peptic ulcer disease include; intractability, gastr ic outlet obstruction, acute perforation, and bleeding uncontrolled by endo scopic intervention. H. pylori has also been shown to be associated with an increased risk of gastric adenocarcinoma and surgical exploration may play a role in diagnosis, staging and treatment. Finally, the relationship betw een H. pylori infection and the development of gastric MALT lymphoma is wel l established. While treatment for H. pylori infection is indicated for low grade MALT lymphomas, surgical resection may be indicated for treatment fa ilures, as well as for certain high grade lesions.