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Open versus laparoscopic technique in peptic ulcus perforation, how effective are score systems?Single-center
Emrah Akin1, Fatih Altintoprak2, Yesim Akdeniz1
1Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya-Türkiye.
Insights
Laparoscopic surgery for peptic ulcer perforation (PUP) shows lower complication rates compared to open surgery. This minimally invasive approach offers a safe alternative for PUP treatment.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Peptic ulcer perforation (PUP) is a significant cause of morbidity and mortality.
- Comparing surgical outcomes for PUP is crucial for patient management.
- Pre-operative scoring systems aid in risk stratification for PUP patients.
Purpose of the Study:
- To compare outcomes of laparoscopic versus open surgery for peptic ulcer perforation (PUP).
- To evaluate the safety and efficacy of different surgical approaches in PUP.
- To assess patient outcomes based on pre-operative scoring indices and surgical type.
Main Methods:
- Retrospective analysis of emergency PUP patient files.
- Calculation of pre-operative Boey, Charlson Comorbidity Index (CCI), and Mannheim Peritonitis Index (MPI) scores.
- Comparison of laparoscopic (Group-1) and open surgery (Group-2) outcomes.
Main Results:
- No significant differences in demographics, hospital admission, or length of stay between groups.
- Laparoscopic surgery had a longer operative time (110.2 min) than open surgery (54.2 min) (p<0.001).
- Morbidity was significantly lower in the laparoscopic group (4%) compared to the open group (14.6%) (p<0.001).
Conclusions:
- Laparoscopic surgery is a safe and effective treatment for peptic ulcer perforation (PUP).
- Minimally invasive surgery for PUP is associated with reduced post-operative complications.
- Laparoscopic approach offers advantages for managing PUP patients.
Background:
One of the most common peptic ulcer complications is perforation (PUP) which also remains an important cause of morbidity and mortality. In this study, it was aimed to compare the results of patients who had similar pre-operative scoring index results (Boey, Charlson Comorbidity Index (CCI) and Mannheim Peritonitis Index (MPI), and type of surgery.
Methods:
Pre-operative Boey, CCI, and MPI scores were calculated by retrospectively examining the files of patients who were operated under emergency conditions with the diagnosis of PUP. The patients divided into two groups those who underwent laparoscopic surgery/Group-1 and open surgery/Group-2.
Results:
There was no statistical difference between the groups in terms of demographic data, hospital admission time, and length of hospital stay. The operation time was found to be longer in the laparoscopic group (110,2 SD20,6/75-150 min) than open group (54,2 SD15,7/30-120 min) (p<0.001). Morbidity was less in laparoscopic group (4% versus 14.6%) (p<0.001).
Conclusion:
The laparoscopic method may be used safely in PUP due to the lower post-operative complication rates and known advantages of minimally invasive surgery.
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