A New and Safer Surgical Technique Figure of Eight Sti T Ch for Management of Perforated Peptic Ulcer

Abstract

There are many methods for closing the perforated peptic ulcer. The technique of closure of perforation by figure of 8 stitch method has been found to be very effective in managing patients with this common problem. MATERIAL AND METHOD: The present study was conducted in Unit III of Department of General Surgery, Government Medical College and Dr. Susheela Tiwari Government Hospital Haldwani, from January 2012 to December 2013 on the cases of peptic ulcer perforation peritonitis. All patients with clinical and radiological features and intraoperative findings suggestive of perforated peptic ulcer were included in the study. RESULTS: A total of 153 patients were included in the study. Out of these, 128 patients (84%) were males and 25 patients (16%) were females. In 120 patients (78%) there was duodenal perforation and in 33 patients (22 %) gastric perforation was present. Out of these 33 patients, 6 patients had posterior gastric perforation. 140 patients were managed with midline laparotomy and 13 with laparoscopic method, with one converted to open due to presence of posterior gastric perforation. The average time of patient reporting to the emergency was3-4 days, with earliest reporting time of 2-3 hours and late reporting up to 7-8 days. Age ranged from 15 years to 90 years (average 35 -45 years). In the postoperative period, 3 patients had leakage from repair site, 7 patients died, rest showed good outcome. CONCLUSION: Figure of 8 stitch method showed very good and acceptable result. Therefore, in our opinion this method should be promoted for surgery of perforated peptic ulcer.

Peptic perforations: comparative study of its closure (omentopexy versus figure of 8 closure)

“…6 Choudhary et al, in their study assessing figure of 8 technique reported that the average time of presentation was between 3-4 days, earliest up to 2-3 hours and delayed up to 7-8 days. 12 Delay in PUD perforation before surgical treatment is a strong determinant for increased complication rates and hospital costs. 13…”