Open versus laparoscopic repair of perforated duodenal ulcer: a comparative study
Keywords:Perforated duodenal ulcer, Laparoscopic repair, Open repair, Omental patch
Background: Surgery is the mainstay of the treatment for perforated duodenal ulcer by closing the perforation with or without omental patch. There are no controversies in the surgical treatment of perforated duodenal ulcer but the best approach to surgery is still debatable. Advances in minimal access surgery has made it possible to close the perforated duodenal ulcer laparoscopically. The present study was conducted to compare the results of open and laparoscopic repair of perforated duodenal ulcer in terms of operative time, postoperative pain, hospital stay, and post-operative complications etc.
Methods: The study was conducted in Dr. V. M. Government Medical College and Hospital located in Solapur (Maharashtra) from December 2008 to December 2010. It was a prospective comparative study. Patients were randomly divided into 2 groups alternately where group A and B were operated by conventional and laparoscopic techniques respectively and their outcomes were compared.
Results: Most commonly affected age in this study was 51 to 60 years with male preponderance. Post-operative pain, analgesic requirement, wound infection, hospital stay, was significantly less in laparoscopic group as compared to open group (p<0.05).
Conclusions: Laparoscopic repair of perforated duodenal ulcer is safe and feasible in properly selected patients and has superior results as compared to open surgery.
Motewar A, Tilak M, Patil D, Bhamare N, et al. Laparoscopic versus open management of duodenal perforation: a comparative study at a District General Hospital. Prz Gastroenterol. 2013;8(5):315-9
Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment, and prognosis. World J Surg. 2000;24(3):277-83.
Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet. 2002;359(9300):14-22.
Ramsoekh D, Leerdam VME, Rauws EA, Tytgat GN. Outcome of peptic ulcer bleeding, nonsteroidal anti-inflammatory drug use, and Helicobacter pylori infection. Clin Gastroenterol Hepatol. 2005;3(9):859-64.
Kucuk HF, Censur Z, Kurt N, Ozkan Z, Kement M, Kaptanoglu L, et al. The effect of Ramadan fasting on duodenal ulcer perforation: a retrospective analysis. Indian J Surg. 2005;67:195-8.
Critchley AC, Phillips AW, Bawa SM, Gallagher PV. Management of perforated peptic ulcer in a district general hospital. Ann R Coll Surg Engl. 2011;93:615-9.
Karydakis P, Semenov DI, Kyriakidis AV. Laparoscopic Management of Perforated Peptic Ulcer. Open J Gastroenterology 2016;6:311-8.
Bertleff MJ, Lange JF. Laparoscopic correction of perforated peptic ulcer: a review of literature. Surg Endosc. 2010;24:1231-9
Katkhouda N, Mavor E, Mason RJ et al. Laparoscopic repair of perforated duodenal ulcers: outcome and efficacy in 30 consecutive patients. Arch Surg. 1999;134(8):845-50.
Golash V. Ten-Year Retrospective Comparative Analysis of Laparoscopic Repair versus Open Closure of Perforated peptic ulcer. Oman Med J. 2008;23(4):241-6.
Bhogal RH, Athwal R, Durkin D. Comparison between open and laparoscopic repair of perforated peptic ulcer disease. World J Surg. 2008;32(11):2371-4.
Lunevicius R, Morkevicius M. Systematic review comparing laparoscopic and open repair for perforated peptic ulcer. Br J Surg. 2005;92(10):1195-207.
Mehendale VG, Shenoy SN, Joshi AM, Chaudhari NC. Laparoscopic versus open surgical closure of perforated duodenal ulcers: a comparative study. Indian J Gastroenterol. 2002;21(6):222-4.