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[Laparoscopic treatment of perforated duodenal ulcer]
B Alamowitch1, K Aouad, P Sellam
1Pôle de Chirurgie Viscérale, Service de Chirurgie, Hôtel-Dieu, Paris.
Objective:
The aim of this study was to determine if laparoscopic simple closure for perforated duodenal ulcer is possible, efficient and safe.
Methods:
Thirty-five consecutive patients with perforated duodenal ulcer and peritonitis were treated by simple closure, peritoneal lavage and omentoplasty. This treatment was performed laparoscopically.
Results:
Diagnosis was confirmed in all cases. Conversion to laparotomy was necessary in two patients due to a technical problem and poor tolerance to pneumoperitoneum, respectively. Mean operative time was 120 min. Morbidity and mortality rates were 2.8%. Mean hospital stay was 7.8 days. No recurrence was found after eradication of Helicobacter pylori with a long-term follow-up of 38 months.
Conclusion:
Laparoscopic suture of perforated duodenal ulcer is possible and safe. It can avoid laparotomy with septic complications in peritonitis. In emergency there is no place for radical treatment of ulcer disease because of efficiency of medical treatment.