[Perforated peptic ulcer closure: laparoscopic or open?]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Perforated peptic ulcer (PPU) is a critical surgical emergency.
• Traditional open surgery for PPU has known associated morbidities.
• Laparoscopic techniques are increasingly explored for various abdominal procedures.

Purpose of the Study:

• To compare the efficacy and outcomes of laparoscopic versus open surgical closure for perforated peptic ulcers.
• To evaluate key parameters including surgical time, postoperative pain, complications, and cosmetic results.

Main Methods:

• A comparative study involving 153 patients with perforated peptic ulcers.
• Patients were divided into two groups: 78 undergoing laparoscopic closure and 75 undergoing open suturing via laparotomy.
• Outcomes assessed included surgery duration, pain severity, analgesic use, complications, hospital stay, and cosmetic appearance.

Main Results:

• Laparoscopic PPU closure demonstrated significantly reduced postoperative pain, analgesic requirements, and complication rates.
• Excellent cosmetic results were observed with the laparoscopic approach.
• Surgical time was longer in the laparoscopic group compared to the open group.
• No significant difference in hospital stay was noted between the two groups.

Conclusions:

• Laparoscopic suturing of perforated peptic ulcers is a safe and effective alternative to open surgery, particularly in experienced hands.
• The laparoscopic approach offers significant benefits in terms of pain reduction, complication rates, and cosmetic outcomes.
• Further research is warranted to standardize laparoscopic techniques and fully elucidate their long-term safety and advantages.