[Laparoscopic approach in the treatment of perforated gastroduodenal ulcer]

The authors report on their experience with the treatment of 34 consecutive patients suffering from perforated peptic ulcer with peritonitis. All patients has been treated by the laparoscopic approach using sutures according to the Graham-Steele technique and omental plication. Irrigation, suction of the entire abdominal cavity with isotonic sodium chloride solution and drainage completed the procedure. In three cases, after an initial laparoscopic operation, we converted to laparotomy because of a large or unusually positioned ulcer. The morbidity rate was low and one patient died of myocardial infarction. The mean hospital stay was seven days. The method, which requires good laparoscopic experience, is simple, allows thorough toilette, has a low morbidity and is safe for the patient.