What is the treatment of choice in duodenal ulcer without any complication of hemorrhage?

Proton pump inhibitors like Omeprazole can produce relief in patients with duodenal ulcer. Perforation complicates duodenal ulcer about half as often as bleeding and most perforated ulcers are on the anterior surface of the duodenum. The patient population tends to be elderly (mean age 60-70), chronically, ill patients often (40-50%) taking ulcerogenic medication. Helicobacter pylori is implicated in 70-92% of all perforated duodenal ulcers even if those secondary to Non-Steroidal Antiinflammatory Drugs are included. The second most common cause of perforated duodenal ulcer is the ingestion of Non-Steroidal Antiinflammatory drugs. The traditional management of a perforated duodenal ulcer has been a Graham Omental Patch and a thorough abdominal lavage.