[Fast-track recovery for perforated duodenal ulcer]

Area of Science:

• Surgical Gastroenterology
• Critical Care Medicine
• Perioperative Management

Background:

• Perforated duodenal ulcer (PDU) is a critical surgical emergency requiring prompt intervention.
• Traditional management often involves lengthy hospital stays and significant complication rates.
• Enhanced recovery pathways aim to optimize patient recovery and reduce resource utilization.

Purpose of the Study:

• To evaluate the outcomes of a fast-track recovery protocol in patients with perforated duodenal ulcer.
• To compare the efficacy of laparoscopic suturing with enhanced recovery versus conventional treatments.
• To assess complication rates, length of hospital stay, and patient discharge safety.

Main Methods:

• A comparative study involving 138 patients with PDU from 2015-2019.
• Patients were divided into three groups: fast-track (laparoscopic suturing + enhanced recovery), control 1 (open suturing + conventional care), and control 2 (laparoscopic suturing + conventional care).
• Complications were graded using the Clavien-Dindo system.

Main Results:

• The fast-track group had significantly lower complication rates (3.92%) compared to control groups (27.27% and 9.3%).
• Mean hospital stay was substantially reduced in the fast-track group (3.86 days) versus control groups (7.56 and 6.7 days).
• No mortality was observed in the fast-track group, contrasting with 4.54% in control group 1.

Conclusions:

• Laparoscopic suturing combined with a fast-track recovery protocol is effective for managing perforated duodenal ulcers.
• This approach leads to reduced postoperative complications and shorter hospital stays.
• The fast-track protocol facilitates early and safe patient discharge, improving overall treatment outcomes.