Routine use of laparoscopic repair for perforated peptic ulcer

Siu, Wing Tai; Chau, Chun Han; Law, Bonita Ka Bo; Tang, Chung Ngai; Ha, Ping Yiu; Li, M. K. W.

doi:10.1002/bjs.4452

Cited by 106 publications

(86 citation statements)

References 16 publications

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“…53,54 In our study pre pyloric perforation was commonest site while other investigators had reported first part of duodenum as common site for ulcer location. 15,51,55 However all share the common pathophysiology with acid hyper secretion and high prevalence of helicobacter pylori infection. 56,57 In our study Modified Graham's patch with a pedicle omental patch repair was done in all cases with routine eradication of helicobactor pylori infection to avoid recurrences and re-perforation.…”

Section: Discussionmentioning

confidence: 99%

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

2016

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Section: Discussionmentioning

confidence: 99%

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

2016

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“…Artık günümüzde konvansiyonel laparotomi yerine endoskopik ve laparoskopik yardımcı yöntemler tedavi aşamasında artan oranlarda kullanılmaktadır. [2,3] Tedavi seçeneklerinin çeşitli olması ve acil karar verme zorunluluğu nedeniyle gö-rüntülemede yanıtlanması gereken temel soru perforasyonun yeri ve nedeninin ortaya konmasıdır. Doğru tedavinin planlanması için perforasyonun varlığı, yeri ve nedeni belirlenmelidir.…”

Section: Resultsunclassified

The Role of Abdominal CT in Determining Perforation Findings and Site in Patients with Gastrointestinal Tract Perforation.

Ilgar¹,

Elmalı²,

Nural³

2013

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada gastrointestinal kanal perforasyonlu hastalarda karın bilgisayarlı tomografisinin (BT) perforasyon bulguları ve perforasyon yerini belirlemedeki rolü araştırıldı. GEREÇ VE YÖNTEMTemmuz 2007 ve Temmuz 2010 tarihleri arasında, gastrointestinal kanal perforasyonu olduğu cerrahi olarak kanıtlan-mış 47 hastanın ameliyat öncesi karın BT görüntüleri geriye dönük olarak değerlendirildi. Her bir hasta için BT'de serbest hava, kontrast madde kaçağı, duvar kalınlaşması, duvar devamsızlığı, apse, flegmon ve serbest sıvı varlığı araştırıldı. Belirlenen bu bulgular ışığında perforasyon yeri tahmin edildi ve cerrahi sonuçlar ile karşılaştırıldı. BULGULARKarın BT bulgularına göre gastroduodenal perforasyonu olan hastaların %85,7'sinde, ince bağırsak perforasyonu olanların %85,7'sinde, kalın bağırsak perforasyonu olanların %69,2'sinde, rektum perforasyonu olanların %100'ünde, apendiks perforasyonu olanların %90,9'unda, tüm hastaların ise %82,9'unda perforasyon yeri doğru olarak belirlendi. Gastrointestinal kanal perforasyonunda BT'de en sık rastlanan bulgu %89,4 oranı ile karında serbest sıvı idi. Diğer bulguların rastlanma oranları ise sı-rasıyla şöyleydi; serbest hava %76.6, segmental duvar kalınlaşması %48.9, duvar devamsızlığı %25.5, apse %12.8, flegmon %10,6. Oral kontrast kullanılan 30 hastanın 7'sinde (%23,3) ekstraluminal kontrast kaçağı saptandı. SONUÇBT gastrointestinal kanal perforasyon bulgularını ve perforasyon yerini belirlemede oldukça etkilidir.Anahtar Sözcükler: Bilgisayarlı tomografi; intestinal perforasyon; spiral bilgisayarlı tomografi.

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“…Minimal access surgery was associated with a significantly lower wound infection, reduced postoperative pain and analgesic consumption, a lower mortality rate and a shorter hospital stay [13][14][15][16][18][19][20]. Laparoscopy is also preferred when managing patients with acute abdomen and no radiographic changes [21]. However, this technique has a longer operating time and is not recommended for hypotensive patients, patients with a coexisting medical disease or previous upper abdominal surgery, in critical condition and in the presence of some technical difculties or large ulcers [13][14][15][16][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

Baltrūnaitė¹,

Trainavičius²

2015

LietChirur

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ObjectivesPerforated peptic ulcer (PPU) is a rare but life-threatening surgical emergency in childhood. The aim of our study was to analyse the clinical features, diagnosis and management of PPU in children. MethodsThe data of children diagnosed with gastroduodenal PPU at Children's Surgery Department, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos from 1994 to 2012 were reviewed. The patients' age, sex, anamnesis, clinical features, examination results, operative findings and methods, medication therapy and outcomes were assessed. Statistical analysis was performed using MS Excel. Results There were 14 (93.3%) males and one female aged 14 to 18 years (16.3 ± 1.3) included in the study. Twelve patients (80%) were diagnosed with gastric and 3 (20%) with duodenal PPU. Eleven patients (73.3%) had dyspepsia before PPU, of them 4 had a history of peptic ulcer disease. Most patients (46.6%) arrived to the hospital within 6 hours of symptom onset. All presented with severe epigastric pain, 8 (53.3%) with nausea and vomiting. Only one patient (6.6%) complained of melena. One (6.6%) suffered from epigastric pain radiating to the left shoulder. Physical examination revealed positive peritoneal signs in 13 patients (86.6%). Subdiaphragmatic free air was detected in 12 patients (80%). The mean duration of perforation was 34.47 ± 57.41 hours (2-178). Thirteen patients (86.6%) underwent laparotomy, 2 laparoscopic repair. The anterior wall of the prepyloric gastric region was the commonest perforation site (80%). Eight patients (53.4%) had a course of H. pylori eradication therapy. The average hospital stay was 10.6 ± 6.3 days (4-32). Fourteen patients (93.3%) had an uneventful postoperative period, one developed nephrotic range proteinuria. All recovered fully. Klinikinė praktika 39Perforated peptic ulcer in children: diagnosis and treatment ConclusionsGastroduodenal PPU should be suspected in adolescent boys with a sudden onset of severe abdominal pain, positive peritoneal signs, and confirmed by pneumoperitoneum in the plain X-ray. Simple closure and eradication of H. pylori (when infection confirmed) are mandatory for a complete recovery. Key words: gastric ulcer, duodenal ulcer, perforated peptic ulcer, children Darbo tikslasSkrandžio ar dvylikapirštės žarnos opos perforacija yra reta, tačiau gyvybei pavojinga vaikų būklė. Darbo tikslas -išanalizuoti vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų kliniką, diagnostiką ir gydymą. Tyrimo medžiaga ir metodai Atlikta retrospektyvi ligonių, 1994-2012 m. gydytų Vaikų ligoninės VUL SK filialo Vaikų chirurgijos skyriuje, duomenų analizė. Vertinta ligonių amžius, lytis, anamnezė, klinika, fizinio ir instrumentinio ištyrimo duomenys, operacijos radiniai, metodai ir trukmė, medikamentinė terapija ir ankstyvosios komplikacijos. Statistinė duomenų analizė atlikta MS Excel programa. Rezultatai Buvo tirta 15 vaikų: 14 (93,3 %) berniukų ir 1 (6,6 %) mergaitė. Vidutinis ligonių amžius buvo 16,3±1,3 metų. Dvylikai (80 %) ligonių diagnozuota skr...

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Routine use of laparoscopic repair for perforated peptic ulcer

Abstract: Laparoscopic repair of perforated peptic ulcer is a safe emergency procedure in routine clinical practice for patients with perforated pyloroduodenal ulcer.

Cited by 106 publications

References 16 publications

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

The Role of Abdominal CT in Determining Perforation Findings and Site in Patients with Gastrointestinal Tract Perforation.

Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

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