PMID- 31921329 OWN - NLM STAT- MEDLINE DCOM- 20210319 LR - 20231113 IS - 1749-7922 (Electronic) IS - 1749-7922 (Linking) VI - 15 DP - 2020 TI - Perforated and bleeding peptic ulcer: WSES guidelines. PG - 3 LID - 10.1186/s13017-019-0283-9 [doi] LID - 3 AB - BACKGROUND: Peptic ulcer disease is common with a lifetime prevalence in the general population of 5-10% and an incidence of 0.1-0.3% per year. Despite a sharp reduction in incidence and rates of hospital admission and mortality over the past 30 years, complications are still encountered in 10-20% of these patients. Peptic ulcer disease remains a significant healthcare problem, which can consume considerable financial resources. Management may involve various subspecialties including surgeons, gastroenterologists, and radiologists. Successful management of patients with complicated peptic ulcer (CPU) involves prompt recognition, resuscitation when required, appropriate antibiotic therapy, and timely surgical/radiological treatment. METHODS: The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the board of the WSES to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the 5th WSES Congress, and for each statement, a consensus among the WSES panel of experts was reached. CONCLUSIONS: The population considered in these guidelines is adult patients with suspected complicated peptic ulcer disease. These guidelines present evidence-based international consensus statements on the management of complicated peptic ulcer from a collaboration of a panel of experts and are intended to improve the knowledge and the awareness of physicians around the world on this specific topic. We divided our work into the two main topics, bleeding and perforated peptic ulcer, and structured it into six main topics that cover the entire management process of patients with complicated peptic ulcer, from diagnosis at ED arrival to post-discharge antimicrobial therapy, to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process. CI - (c) The Author(s). 2020. FAU - Tarasconi, Antonio AU - Tarasconi A AUID- ORCID: 0000-0001-6588-2268 AD - 1Emergency Surgery Department, Parma University Hospital, Parma, Italy. FAU - Coccolini, Federico AU - Coccolini F AD - 2General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy. FAU - Biffl, Walter L AU - Biffl WL AD - 3Scripps Memorial Hospital La Jolla, La Jolla, CA USA. FAU - Tomasoni, Matteo AU - Tomasoni M AD - 4General, Emergency and Trauma Surgery Department, Bufalini hospital, Cesena, Italy. FAU - Ansaloni, Luca AU - Ansaloni L AD - 4General, Emergency and Trauma Surgery Department, Bufalini hospital, Cesena, Italy. FAU - Picetti, Edoardo AU - Picetti E AD - 5Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. FAU - Molfino, Sarah AU - Molfino S AD - 6Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. FAU - Shelat, Vishal AU - Shelat V AD - 7Tan Tock Seng Hospital, Singapore, Singapore. FAU - Cimbanassi, Stefania AU - Cimbanassi S AD - 8General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano, Milan, Italy. FAU - Weber, Dieter G AU - Weber DG AD - 9Royal Perth Hospital, Perth, Australia & The University of Western Australia, Crawley, Australia. FAU - Abu-Zidan, Fikri M AU - Abu-Zidan FM AD - 10Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates. FAU - Campanile, Fabio C AU - Campanile FC AD - Division of Surgery, ASL VT - Ospedale "Andosilla", Civita Castellana, Italy. FAU - Di Saverio, Salomone AU - Di Saverio S AD - 12Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. FAU - Baiocchi, Gian Luca AU - Baiocchi GL AD - 6Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. FAU - Casella, Claudio AU - Casella C AD - 13Department of Molecular and Translational Medicine, Surgical Clinic, University of Brescia, Brescia, Italy. FAU - Kelly, Michael D AU - Kelly MD AD - Department of General Surgery, Albury Hospital, Albury, Australia. FAU - Kirkpatrick, Andrew W AU - Kirkpatrick AW AD - 15General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta Canada. FAU - Leppaniemi, Ari AU - Leppaniemi A AD - 16Helsinki University Hospital, Helsinki, Finland. FAU - Moore, Ernest E AU - Moore EE AD - 17Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO USA. FAU - Peitzman, Andrew AU - Peitzman A AD - 18University of Pittsburgh, School of Medicine, UPMC - Presbyterian, Pittsburgh, PA USA. FAU - Fraga, Gustavo Pereira AU - Fraga GP AD - 19Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP Brazil. FAU - Ceresoli, Marco AU - Ceresoli M AD - 20Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. FAU - Maier, Ronald V AU - Maier RV AD - 21Department of Surgery, Harborview Medical Centre, University of Washington, Seattle, USA. FAU - Wani, Imtaz AU - Wani I AD - 22Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India. FAU - Pattonieri, Vittoria AU - Pattonieri V AD - 1Emergency Surgery Department, Parma University Hospital, Parma, Italy. FAU - Perrone, Gennaro AU - Perrone G AD - 1Emergency Surgery Department, Parma University Hospital, Parma, Italy. FAU - Velmahos, George AU - Velmahos G AD - 23Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, USA. FAU - Sugrue, Michael AU - Sugrue M AD - Letterkenny University Hospital, Donegal Clinical Research Academy Centre for Personalized Medicine, Donegal, Ireland. FAU - Sartelli, Massimo AU - Sartelli M AD - Department of Surgery, Macerata Hospital, Macerata, Italy. FAU - Kluger, Yoram AU - Kluger Y AD - 26Department of General Surgery, Rambam Health Care Campus, Haifa, Israel. FAU - Catena, Fausto AU - Catena F AD - 1Emergency Surgery Department, Parma University Hospital, Parma, Italy. LA - eng PT - Journal Article PT - Practice Guideline DEP - 20200107 PL - England TA - World J Emerg Surg JT - World journal of emergency surgery : WJES JID - 101266603 SB - IM MH - Adult MH - Combined Modality Therapy MH - Evidence-Based Medicine MH - Humans MH - Peptic Ulcer Hemorrhage/*therapy MH - Peptic Ulcer Perforation/*therapy PMC - PMC6947898 OTO - NOTNLM OT - Angiography OT - Antibiotics OT - Diagnosis OT - Embolization OT - Guidelines OT - High-risk patients OT - Intra-abdominal infection OT - Non-operative management OT - Pancreatitis OT - Peptic ulcer OT - Peritonitis OT - Surgery OT - Technique OT - Timing COIS- Competing interestsThe authors declare that they have no competing interests. EDAT- 2020/01/11 06:00 MHDA- 2021/03/20 06:00 PMCR- 2020/01/07 CRDT- 2020/01/11 06:00 PHST- 2019/10/24 00:00 [received] PHST- 2019/12/18 00:00 [accepted] PHST- 2020/01/11 06:00 [entrez] PHST- 2020/01/11 06:00 [pubmed] PHST- 2021/03/20 06:00 [medline] PHST- 2020/01/07 00:00 [pmc-release] AID - 283 [pii] AID - 10.1186/s13017-019-0283-9 [doi] PST - epublish SO - World J Emerg Surg. 2020 Jan 7;15:3. doi: 10.1186/s13017-019-0283-9. eCollection 2020.