Gastric ulcer after laparoscopic fundoplication for gastroesophageal reflux disease: significance of the eradication of Helicobacter pylori.

The occurrence of gastric ulcers after laparoscopic fundoplication for gastroesophageal reflux disease is not uncommon. Between December 1994 and December 2004, we performed laparoscopic fundoplication in 180 patients, of whom 4 (2.2%) men developed a gastric ulcer during follow-up. The ulcers occurred predominantly in the upper part of the lesser curvature of the stomach, which is definitely different from the usual location of gastric peptic ulcers. All cases we experienced had Helicobacter pylori infection and eradication was attempted in all of them. Although eradication was not possible in 1 patient because of adverse effects to the drugs, successful eradication was obtained in the remaining 3 patients. After successful eradication, these 3 patients were placed under observation without medication and the ulcer has not recurred. The eradication of H. pylori may be an effective therapeutic means to prevent gastric ulcers recurrence after fundoplication.