Open vs laparoscopic repair of perforated peptic ulcer

Abstract

The laparoscopic repair of perforated peptic ulcer does not yield any additional benefits over the open repair.

Risk factors influencing the early outcome results after laparoscopic repair of perforated duodenal ulcer and their predictive value

“…Our laparoscopic patients were younger and had lower preoperative risk according to ASA and Boey scores compared to data published by other authors. In the study of Lee et al [17], the mean patient age was 51.5±18.3 years, Agresta [11,18] indicated 59 years (minimum 28; maximum 79), Bergamaschi et al [10] 69 years (minimum 27; maximum 83), So et al [8] 46 years (minimum 20, maximum 67), Naesgaard et al [13] 69 years (minimum 37, maximum 84), Matsuda et al [12] 39.8 years. In the study of Bergamaschi et al [10], two patients had I grade, six had II grade, five had III, and four had IV grade evaluation according to ASA.…”

“…There was also a significantly increased rate of pneumonia: in two patients (50%) with suture leak compared to one patient (1.7%) in the group of patients without suture leak (p=0.010; Fisher's exact test). Alhough none of proposed risk factors was found to be a reliable indicator of increased risk for suture leakage using univariate analysis (Table 4), we further analyzed the differential duration of duodenal ulcer perforation cut-off values (4,6,8,9,10,12, and 24 h) and compared their propensity to predict suture leak in early postoperative period (Table 5). Because this is a serious and potentially fatal complication, we were looking for stratification criteria that would enable the surgeon to qualify all patients with suture leakage as high risk in the preoperative period.…”

“…Although some studies claim the superiority of laparoscopic in terms of shorter operative time and faster and less painful recovery [4][5][6][7][8], other authors find no such advantage [9][10][11][12] and some state that open repair is a safer alternative for patients with peritonitis due to perforated duodenal ulcers [13]. The latest metaanalysis comparing the safety and efficacy of open and laparoscopic repair of perforated peptic ulcers revealed that laparoscopic repair confers superior shortterm benefits in terms of postoperative pain and wound complications, and it is as safe and effective as open repair [14].…”

Surgical treatment of perforated gastroduodenal peptic ulcers: comparison between open and laparoscopic approach

“…13,15 It is reasonable to obtain a biopsy, even with laparoscopy, but this will enlarge the hole and make closure more technically challenging. 16,17 In our technique we excised ulcer borders laparoscopically or took biopsy with intraoperative endoscopy.…”

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

“…16,17 Newer Technique Like "Stamp Method" with a patch, made up of lactide-glycolid-caprolactone (LGC) was cut into a circle with a diameter of 1 cm and an overlap of 0.5 cm all around the perforation. The patch was glued on the outside of the stomach with Glubran 2 (n-butyl.…”