[Treatment of duodenal ulcer and its complications in the era of Helicobacter pylori. When and how long is the gastroenterologic-internal medicine therapy indicated and when is the surgical treatment necessary?].

With the widespread use of modern H2-receptor antagonists, the proton pump inhibitors and Helicobacter pylori eradication therapy the number of antiulcer operations decreased spectacularly. The treatment of uncomplicated ulcus duodeni got nearly exclusively into internists' hands. Becoming enthusiastic over the excellent results of conservative therapy there are unjustified attempts to avoid the operation in the complications of ulcus duodeni, particularly in bleeding, but also often in perforation and stenosis. With the use of operation-substitute procedures the patients often get in a more unfavourable situation than an operation would offer performed in time and in acceptable conditions. The authors on the basis of their surgical experiences summarize in what cases the deliberation of surgical indication or the performance of an operation is needed in the era of Helicobacter pylori.