Objective:
We aimed to investigate, in a retrospective manner, technical characteristics and clinical outcome of our experience in laparoscopic repair of peptic ulcer perforation.
Material and Methods:
Patients who underwent laparoscopic repair of peptic ulcer perforation between June 1997 and May 2007 were included into the study. Those who underwent open repair or were subjected to conversion from laparoscopy to laparotomy were excluded. Poor general status, severe sepsis, septic shock and hemodynamic instability were considered as contraindications for laparoscopy. Demographic features, technical details and clinical outcome were retrospectively evaluated. Laparoscopic repair was performed via four trocars with primary suturing and intracorporeal knotting.
Results:
Ninety-six patients underwent laparoscopic surgery due to peptic ulcer perforation. Sixty-six patients (69%) underwent laparoscopic repair alone or laparoscopic repair with omentoplasty. In the remaining thirty patients (31%) the procedure was converted to laparotomy. Amongst sixty-six patients who were included into the study, fifty-one patients (77%) were male and fifteen (23%) were female; the mean age was 39.6 (15-80). In thirteen patients (20%; 13/66) preoperative diagnosis was unclear and the patients were taken to the operating theater because of acute abdomen. In all patients, but one, duodenal defect was repaired by primary suturing; in one patient, simply intraabdominal lavage and drainage were performed. Omentoplasty was performed in 35 (53%) patients. One and two abdominal drains were used in 46 (70%) and 20 (30%) respectively. The mean hospital stay was 6.3 (3-20) days. Morbidity was 8% (n=5). Early morbidity included bile leakage in three patients and postoperative intraabdominal bleeding in one. One patient had trocar site hernia as a late complication. There was no mortality.
Conclusion:
Laparoscopic primary repair is a safe and efficient method in peptic ulcer perforation
Keywords: Peptic ulcer, laparoscopy, perforation, laparoscopic repair