TITLE:
Laparoscopic Repair of Perforated Duodenal Ulcer (Series of 50 Cases)
AUTHORS:
S. Abdelaziem, Mohamed S. Hashish, Ahmed Nafea Suliman, David Sargsyan
KEYWORDS:
Laparoscopy, Perforation, Peptic Ulcer, Omental Patch
JOURNAL NAME:
Surgical Science,
Vol.6 No.2,
February
15,
2015
ABSTRACT:
Background:Perforated
peptic ulcer is a common surgical emergency. The classic treatment is the
mid-line laparotomy. However, laparoscopic treatment has been shown to be
reliable. Few studies have evaluated its overall utility. The aim of this study
is to assess the efficacy of laparoscopic repair of perforated duodenal
ulcer.Patients and Methods:This study
included 50 patients presented by perforated peptic ulcer between July 2009 and
August 2014. They were submitted to laparoscopic omental patch repair with
thorough peritoneal wash. Patients’ demographics, diagnostic techniques,
management and outcome were evaluated. Results:The
mean age was 38.6 years with male to female ratio being 1.6:1. The perforation
was diagnosed by plain X-ray abdomen in erect position in 43 patients and by
abdominal CT scan in 7 patients. The laparoscopic repair of the perforation was
successful in 48 patients while in 2 patients mid-line laparotomy was needed
for proper control of the severe intra-abdominal sepsis. Post-operatively, all
patients tolerated soft diet on the 3rdpost-operative day and
full diet on the 4thpost-operative day. The mean duration of
hospital stay was 4.5 days. Two patients developed post-operative
intra-abdominal collection that was treated by ultrasound guided drainage,
three patients developed umbilical port site wound infection while only two
patients developed leakage, one of them reoperated after failed conservative
surgery. No mortality was encountered in the study. Conclusion:Laparoscopic
repair of perforated peptic ulcer is a safe and reliable technique with
accepted morbidity and mortality rates with all the advantages of the minimally
invasive surgery.