Laparoscopic Repair for Perforated Peptic Ulcer

Siu, Wing Tai; Leong, Hio Teng; Law, Bonita Ka Bo; Chau, Chun Han; Li, Anthony C. N.; Fung, Kai-hung; Tai, Yuk Ping; Li, Michael K.W.

doi:10.1097/00000658-200203000-00001

Cited by 300 publications

(326 citation statements)

References 44 publications

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“…Another study conducted by Gupta and Kaushik shows the same result [9]. It is noticed in our study that proper hydration, good antibiotic cover, and simple closure of the perforation using an omentopexy significantly decrease mortality rate [10]. There are other treatment options for perforated peptic ulcer such as Billroth I, Billroth II, and truncal vagotomy drainage procedure [11,12].…”

Section: Discussionsupporting

confidence: 74%

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Yadav

Garg

2012

Indian J Surg

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Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

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Section: Discussionsupporting

confidence: 74%

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Yadav

Garg

2012

Indian J Surg

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“…Siu et al [3] in their study of 121 patient of which 98 (81%) were male. They did laparoscopic repair of perforated peptic ulcer.…”

Section: Laparoscopic Treatment Of Perforated Ulcermentioning

confidence: 95%

Study of role of laparoscopy in acute abdomen

Jamma¹,

Jadhav

2015

Int Jour of Biomed Res

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Study regarding role of laparoscopy in acute abdomen was conducted at Shree Chhatrapati Shivaji Maharaj Sarvopachar Rugnalaya, Solapur during the period from May 2004 to November 2006. Patients of both sex and all age groups were included in the study. A total 30 patients were studied and results were as tabulated and analysed.In this study, total laparoscopic management was possible in 23 cases (76.7%) while laparoscopy assisted surgery were done in 4 cases (13.3%). In this study, 5 cases presented as adhesive small bowel obstruction, 1 with inflamed Meckels diverticulum and 1 as case of ileoileal intussusception. All these findings were missed on radiological investigations, but werediagnosed accurately on laparoscopy. Laparoscopic treatment was done in 9 cases presented as acute abdomen due to intestinal obstruction. This incidence is equal to that of acute cholecystitis. Of these, 5 patients (55.6%) were due to post operative adhesions. We conclude that laparoscopy is valuable, safe feasible and accurate alternative for management of patients of acute abdomen. It is very useful for final diagnosis of patients of acute abdomen. Even negative laparotomies can be avoided using laparoscopy. Therapeutic laparoscopy can be accomplished in majority of patients of acute abdomen.

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“…Simple closure with omental patch has been always the favored method for the emergency procedures. The laparoscopic duodenal perforation repair give benefit of less post-operative pain, early return to normal work and less wound infection but at the same time laparoscopic procedure needs the expertise training, which limits its wide acceptibilty (14). This article is about the technique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

Babu

Raikhy

Ghosh

et al. 2017

J Minim Invasive Surg Sci

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Background: Laparoscopic repair of duodenal perforation using the omental patch is one of the traditional techniques, which gives better postoperative recovery in patients with little chances of abdominal wound infection. This article is about the technique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique. Methods: In Hanging method of duodenal repair first, an intra-corporeal suture is taken at the upper margin of perforation and both end of the thread is taken out of anterior abdominal wall and duodenum is pulled up. Now under vision the next two parallel sutures are passed, thus avoiding the posterior duodenal wall incorporation. Finally omentum flap is used for the closure of perforation. Conclusions:The laparoscopic closure of the duodenal perforation by "Hanging Method" is an appropriate Laparoscopic technique, as "hanging" the anterior wall of duodenum gives us better vision of the posterior wall of duodenum, while taking the suture through anterior duodenal wall. Further since the gall bladder is retracted there is an easy available working space for intracorporeal suturing.

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Laparoscopic Repair for Perforated Peptic Ulcer

Cited by 300 publications

References 44 publications

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Study of role of laparoscopy in acute abdomen

Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

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