All of the following are indications for surgery in a case of duodenal ulcer except;

Surgery is more often required for treatment of an ulcer-related complication. Hemorrhage is the most common ulcer-related complication, Bleeding most often seen in older patients (sixth decade or beyond). Patients unresponsive or refractory to endoscopic intervention will require surgery (-5% of transfusion-requiring patients). Free peritoneal perforation occurs in -2-3% of Duodenal ulcer patients. Concomitant bleeding may occur in up to 10% of patients with perforation, with moality being increased substantially. Peptic ulcer can also penetrate into adjacent organs, especially with a posterior DU, which can penetrate into the pancreas, colon, liver, or biliary tree. Pyloric channel ulcers or DUs can lead to gastric outlet obstruction in -2-3% of patients. If a mechanical obstruction persists, endoscopic intervention with balloon dilation may be effective. Surgery should be considered if all else fails