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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience

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Marginal ulcer perforation: a single center experience.

S K Natarajan^1,2, D Chua³, K Anbalakan⁴

¹Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore. nsureshkhanna2003@yahoo.co.in.

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society

|September 14, 2016

Summary

Marginal ulcer perforation (MUP) in gastrojejunostomy (GJ) patients rarely causes septic shock. Simple repairs like omental patch or primary closure are often sufficient, avoiding mandatory GJ revision.

Keywords:

Marginal ulcer Marginal ulcer perforation

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Area of Science:

Gastroenterology
Surgical Gastroenterology
Abdominal Surgery

Background:

Marginal ulcers (MU) occur at the gastrojejunostomy (GJ) anastomosis.
Complicated MUs, such as perforation (MUP), often necessitate surgical intervention.
Current recommendations suggest revising the GJ anastomosis for MUP.

Purpose of the Study:

To investigate the clinical presentation of marginal ulcer perforation (MUP).
To evaluate the management strategies for MUP.
To assess the outcomes of different MUP repair techniques.

Main Methods:

A retrospective case series of 332 patients undergoing emergency surgery for perforated peptic ulcer over 5 years.
Analysis focused on patients presenting with MUP.

Main Results:

Nine patients (2.7%) presented with MUP, all on the jejunal side of the GJ.
No MUP patients exhibited septic shock.
Omental patch repair (44.4%) and primary closure (33.3%) were common, with no post-operative leaks, abscesses, or reoperations.

Conclusions:

Marginal ulcer perforation (MUP) does not typically lead to septic shock.
Omental patch repair or primary closure are effective management options for MUP.
Revision of gastrojejunostomy (GJ) anastomosis is not always mandatory for MUP.