Abstract: Objective To evaluate the rationality of proton pump inhibitors (PPIs) in the prevention of stress ulcer（SU） during perioperative period of biliary and pancreatic surgery, and to provide reference for the rational use of PPIs. Methods A retrospective survey was conducted to collect information on 478 patients who used PPIs during the perioperative period in the Department of Biliary and Pancreatic Surgery of a certain hospital from June to August 2020. The usage rate and medication indications of PPIs were statistically analyzed. Subsequently, drug selection, medication timing, usage and dosage of cases with medication indications were evaluated. Results Among 623 surgeries, PPIs were used for prevention in 530 cases, accounting for 85.07% of the cases. Among them, 268 cases (50.57%) had no indication of PPIs medication. The cases with medication indications, were mainly due to inappropriate drug selection, inappropriate timing of administration, inappropriate frequency of administration, and overly long treatment periods. The majority of patients exhibited multiple inappropriate medication situations, with only 11 cases (2.08%) being relatively rational. Conclusion The unreasonable phenomenon of using PPIs to prevent stress ulcer in the perioperative period of biliary and pancreatic surgery in the hospital is significant. Physicians should strictly control medication indications, and pharmacists should strengthen pre prescription review to jointly promote rational drug use.

Key words: pancreato-biliary surgery, proton pump inhibitors, perioperative, stress related mucosal disease, stress ulcer, prophylaxis, rational use of drug