Laparoscopic Suture Closure of Perforated Duodenal Peptic Ulcer

The aim of this study was to assess the outcome of a continuous series of 30 patients with perforated duodenal peptic ulcers treated by a laparoscopic approach. Between January 1996 and December 1998, 30 patients (24 males, 6 females) with a mean age of 69.2 years were operated on with a laparoscopic approach. Laparoscopic treatment included peritoneal lavage, suture of the perforation, and omental patching in 24 cases. A conversion to laparotomy was necessary in five patients (16.6%). Mean operative time was 92 minutes (range: 58–114) and mean hospital stay was 6 days (range: 4–16). Mortality and morbidity rates were 6.6% (n = 2) and 16.6% (n = 5). With a median follow-up of 12 months, 96% of the patients were in good condition; one patient had recurrent duodenal ulceration. The results of our study show the feasibility of the laparoscopic approach for perforated peptic ulcer repair, with acceptable mortality and morbidity rates.

[1]  R. Cortesini,et al.  Alternative laparoscopic management of perforated peptic ulcers , 1994, Surgical Endoscopy.

[2]  R. Mårvik,et al.  Open vs laparoscopic repair of perforated peptic ulcer , 1998, Surgical Endoscopy.

[3]  L. Blomgren Perforated Peptic Ulcer: Long-term Results after Simple Closure in the Elderly , 1997, World Journal of Surgery.

[4]  J. So,et al.  Comparison between laparoscopic and conventional omental patch repair for perforated duodenal ulcer , 1996, Surgical Endoscopy.

[5]  M. Bar‐Natan,et al.  Delayed gastric emptying after gastric surgery. , 1996, American journal of surgery.

[6]  J. Tate,et al.  Sutureless laparoscopic treatment of perforated duodenal ulcer , 1993, The British journal of surgery.

[7]  K. Leung,et al.  Laparoscopic repair of perforated peptic ulcer , 1992, The British journal of surgery.

[8]  P. Mouret,et al.  Laparoscopic treatment of perforated peptic ulcer , 1990, The British journal of surgery.

[9]  H. Wacha,et al.  [The Mannheim peritonitis index. An instrument for the intraoperative prognosis of peritonitis]. , 1987, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[10]  J. Boey,et al.  Risk stratification in perforated duodenal ulcers. A prospective validation of predictive factors. , 1987, Annals of surgery.

[11]  R. Logan,et al.  RISING FREQUENCY OF ULCER PERFORATION IN ELDERLY PEOPLE IN THE UNITED KINGDOM , 1986, The Lancet.

[12]  E. Spitznagel,et al.  ASA Physical Status Classifications: A Study of Consistency of Ratings , 1978, Anesthesiology.

[13]  T E Kenny,et al.  Proximal gastric vagotomy without drainage for duodenal ulcer: Results after 5–8 years , 1978, The British journal of surgery.