Comparative study between Graham’s omentopexy and modified-Graham’s omentopexy in treatment of perforated duodenal ulcers

Abdallah, Hassan A; Saleem, Abd-El-Aal A

doi:10.4103/ejs.ejs_61_18

Cited by 6 publications

(7 citation statements)

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“…ERAS pathways can be used in emergency surgery cases where there is a risk of repair site leak in perforated duodenal ulcer. Hospital stay duration was significantly less in the early oral feeding group than the traditional postoperative care group, similar to previous studies [ 13 , 18 ]. Early oral feeding after perforated duodenal ulcer repair did not result in the repair site leak in any patients.…”

Section: Discussionsupporting

confidence: 90%

“…In our study, the repair technique was done per the operating surgeon's preference, and there were no differences noted in repair site leakage, consistent with previous studies [ 13 ]. However, two patients in our study presented with septic shock as referred cases received surgery and were admitted to the ICU postoperatively on ventilator support.…”

Section: Discussionsupporting

confidence: 87%

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Early Oral Feeding Compared With Traditional Postoperative Care in Patients Undergoing Emergency Abdominal Surgery for Perforated Duodenal Ulcer

Masood¹,

Viqar²,

Zia³

et al. 2021

Cureus

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Introduction Enhanced recovery after surgery (ERAS) protocols have been widely studied in elective abdominal surgeries with promising outcomes. However, the use of these protocols in emergency abdominal surgeries has not been widely investigated. This study aimed to evaluate ERAS application outcomes via early oral feeding compared to regular postoperative care in patients undergoing perforated duodenal ulcer repairs in emergency abdominal surgeries. Materials and methods We conducted a randomized controlled trial at the Surgical Unit 1 Benazir Bhutto Hospital from August 2018 to December 2019. A total of 42 patients presenting to the emergency department with peritonitis secondary to suspected perforated duodenal ulcer were included in the study. Patients were randomly assigned into two groups. Group A patients followed an ERAS protocol for early oral feeding, and Group B received regular postoperative care (i.e., delayed oral feeding). Our primary outcomes were the length of hospital stay, duodenal repair site leak, the severity of pain (via the visual analog scale), and postoperative ileus duration. Results were analyzed via IBM Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 20.0 (Armonk, NY: IBM Corp.). and chi-square and independent t-tests were applied. Results Patients who received early oral feeding (Group A) showed a shorter length of hospital stay, lower pain scores, and shorter postoperative ileus duration than patients in the traditional postoperative care group. Also, we noted no duodenal repair site leak in the early oral feeding group. The differences between the two groups were statistically significant (P<0.05). Conclusions Based on our results, ERAS protocols that promote early oral feeding can be applied in patients undergoing emergency abdominal surgery for perforated duodenal repair. Early oral feeding in emergency surgery patients can reduce the patient burden on hospitals. In addition, early oral feeding can promote better outcomes and reduced economic burden for patients. Keywords: Perforated duodenal ulcer, ERAS protocol, randomized controlled trial, duodenal repair site leak, length of hospital stay, VAS score, postoperative ileus.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Early Oral Feeding Compared With Traditional Postoperative Care in Patients Undergoing Emergency Abdominal Surgery for Perforated Duodenal Ulcer

Masood¹,

Viqar²,

Zia³

et al. 2021

Cureus

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“…It is the first treatment of choice in early presentation of <12 h of PPU and when the patient is in shock (9,19,43) Recent studies in Africa continue to reveal that omentopexy still produces good results in patients with PPU (10-14). Graham's omentoplasty (plugging) and modified Graham's omental patch repair (omentopexy) are similarly effective repair in terms of morbidity and mortality (33)(34)(35). However, in several occasions with larger perforations the omental plugging seems a better choice to the omental patch reinforcement technique (omentopexy) (1,34,36,37).…”

Section: Operative Managementmentioning

confidence: 99%

“…Graham's omentoplasty (plugging) and modified Graham's omental patch repair (omentopexy) are similarly effective repair in terms of morbidity and mortality ( 33 – 35 ). However, in several occasions with larger perforations the omental plugging seems a better choice to the omental patch reinforcement technique (omentopexy) ( 1 , 34 , 36 , 37 ). A recent prospective study demonstrated a figure of eight primary closure with omental flap reinforcement to be more superior than Graham's omentoplasty (plugging) in terms of decrease leak rate in peptic perforations <2 cm in diameter ( 38 ).…”

Section: Managementmentioning

confidence: 99%

An Overview of Gastroduodenal Perforation

Weledji

2020

Front. Surg.

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“…(8,9) Estos incluyen resección de la perforación con rodamiento de duodeno y antro gástrico en forma de gastrectomía parcial, conversión de la perforación en una piloroplastía, y una gastro-yeyuno anastomosis en omega de Braun, lo cual va ligado a una alta tasa de complicaciones durante el transoperatorio y posoperatorio. (10) En comparación dentro de los métodos quirúrgicos actualmente utilizados existe la comparación inminente entre un método menos invasivo como lo es el cierre laparoscópico, el cual se realiza por primera vez en 1990 con resultados exitosos. ( 11) Sin embargo, dicho procedimiento presenta indicaciones muy específicas como el tiempo de evolución de padecimiento y experiencia quirúrgica de cirujano quien realiza y procedimiento.…”

Section: Introductionunclassified

Reparación de ulcera gástrica prepilorica y duodenal reporte de caso

Aponte-de La Rosa,

Torres-Alvarez,

Navarro-Vidaña

et al. 2021

RSM

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INTRODUCCIÓN: La enfermedad péptica es una patología con una etiología multifactorial, y con complicaciones agudas como la hemorragia y la perforación la cual amerita tratamiento quirúrgico urgente, se estima que presenta una mortalidad entre el 10 % y 40 % especialmente en pacientes de edad avanzada. Los sitios de perforación duodeno es el más frecuente seguido de píloro y antro. OBJETIVO: El objetivo principal es el dar a conocer el manejo quirúrgico, la evolución y el seguimiento de una perforación gástrica.MATERIALES Y MÉTODOS Paciente femenino de 74 años con antecedentes de ingesta de medicamentos como ketorolaco y Saridon desde hace aproximadamente 30 años, casi diariamente, quien presenta dolor abdominal difuso, tipo cólico de inicio súbito.RESULTADOS: Paciente, presento una evolución adecuada evidenciada por el tiempo de estancia intrahospitalaria que fue de 12 días, no presento infecciones intra -hospitalarias, no presento fugas anastomóticas, mejoro estado séptico de ingreso.DISCUSIÓN: Los hallazgos de una doble perforación, una duodenal y una gástrica pre-pilórica las cuales son el primer y segundo lugar en frecuencia de localización, impidieron manejo convencional optando por un procedimiento que fue un cierre primario de perforación duodenal, exclusión pilórica y gastro-yeyuno anastomosis en omega de Braun mecánica.

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Comparative study between Graham’s omentopexy and modified-Graham’s omentopexy in treatment of perforated duodenal ulcers

Cited by 6 publications

References 0 publications

Early Oral Feeding Compared With Traditional Postoperative Care in Patients Undergoing Emergency Abdominal Surgery for Perforated Duodenal Ulcer

Early Oral Feeding Compared With Traditional Postoperative Care in Patients Undergoing Emergency Abdominal Surgery for Perforated Duodenal Ulcer

An Overview of Gastroduodenal Perforation

Reparación de ulcera gástrica prepilorica y duodenal reporte de caso

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