Perforated Peptic Ulcer, Comparison Between Laparoscopic and Open Repair.

authors:

avatar F Karimian 1 , avatar A Aminian 1 , * , avatar AH Lebaschi 2 , avatar R Mirsharifi 3 , avatar A Alibakhshi 1

Assistant Professor,
Resident,
Associate Professor, Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

how to cite: Karimian F, Aminian A, Lebaschi A, Mirsharifi R, Alibakhshi A. Perforated Peptic Ulcer, Comparison Between Laparoscopic and Open Repair.. Shiraz E-Med J. 2009;10(1): 20-6. 

Abstract

Introduction:

Increasing evidence is presenting in favor of laparoscopic repair of perforated peptic ulcer (PPU). A selected group of patients may benefit more with laparoscopic repair than with open surgery. Taking advantage from experiences of other workers, we tried to define this group of patients.

Materials and Methods:

This is a retrospective study comparing laparoscopic repair of PPU with open repair. We excluded patients with shock, generalized peritonitis, previous upper abdominal surgery, large ulcer (>10mm), gastric ulcer, and concomitant peptic ulcer complications from both groups. Closure of perforation in both groups was performed by simple suture closure with omental patch.

Results:

patients underwent laparoscopic repair required less analgesic postoperatively, returned to normal diet earlier, and had a shorter postoperative hospital stay. Laparoscopic repair took more time than open surgery.

Conclusion:

laparoscopic repair of perforated peptic ulcer is advantageous to open surgery by less postoperative pain, earlier return to normal diet, and earlier discharge from hospital. It may be considered as a safe treatment option for selected patients in routine clinical practice.

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