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Laparoscopic Repair of Perforated Peptic Ulcer: Outcome and Associated Morbidity and Mortality
Mahdi Alemrajabi1, Saeed Safari2, Adnan Tizmaghz3
1MD., Assistant Professor of Colorectal Surgery, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
Insights
Laparoscopic surgery for perforated peptic ulcer offers promising outcomes. This study found no morbidity or need for conversion to open surgery, demonstrating the safety and efficacy of the laparoscopic approach.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Perforated peptic ulcer (PPU) traditionally treated with open surgery.
- Laparoscopic surgery is increasingly adopted for PPU management.
- Omental patch closure is the standard surgical technique for PPU.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic surgery for perforated peptic ulcer.
- To assess morbidity, mortality, operation time, conversion rates, and hospital stay.
- To determine the feasibility of laparoscopic omental patch closure for PPU.
Main Methods:
- Prospective analysis of 29 consecutive patients undergoing laparoscopic surgery for PPU.
- Data collected over 18 months (March 2014 - September 2015).
- Analysis of pre-operative, intra-operative, and post-operative clinical data.
Main Results:
- Average operating time was 47.5 minutes; mean symptom-to-surgery lag time was 20.4 hours.
- All patients underwent successful laparoscopic omental patch closure.
- No morbidity or conversion to open surgery was observed; mean hospital stay was 4.2 days.
Conclusions:
- Laparoscopic approach for PPU is safe and effective.
- The technique demonstrated no morbidity or mortality in this cohort.
- Promising results support the use of laparoscopy for perforated peptic ulcer treatment.
Introduction:
The mainstay of treatment for perforated peptic ulcer is Omental patch closure. With the advent of laparoscopic surgery, this approach is being used for the treatment of perforated peptic ulcer. The aim of this study was to evaluate the outcome of laparoscopy in Firoozgar general hospital over a period of 18 months. The outcome of the laparoscopic approach and the associated morbidity and mortality, operation time, conversion rate and hospital stay were assessed.
Methods:
A prospective analysis of 29 consecutive patients (mean age 37.5 years; 23 men) with perforated peptic ulcers and who had undergone laparoscopic surgery was carried over a period of 18 months from March 2014 until September 2015. Pre-operative, intra-operative, and post-operative clinical data were collectively analyzed by SPSS 19 for Windows.
Results:
Seventeen patients had a history of cigarette smoking, 11 patients had a history of opium consumption, 19 were chronic NSAID users, 26 had Helicobacter pylori infections, and six had a co-morbid condition. Previous surgical history included laparotomy for pancreatic cancer in two patients, for sigmoid colon cancer in one patient, and for acute appendicitis in four patients. The average operating time for all cases was 47.5 + 20 min. The mean lag time between onset of symptoms and surgery was 20.4 hours. All patients underwent laparoscopic closure of the perforation with Omental patch closure. No morbidity was observed, and none of the patients needed conversion to open surgery. One patient died after 11 months of follow-up due to the progression of underlying pancreatic cancer. The mean postoperative hospital stay was 4.2 days.
Conclusions:
The results of the laparoscopic approach for perforated peptic ulcer were promising, with no conversion to open surgery, no morbidity, and mortality.
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