Management of perforated large/giant peptic ulcers: a comparative prospective study between omental plug, duodenal exclusion, and jejunal serosal patch | ||
| The Egyptian Journal of Surgery | ||
| Volume 40, Issue 2, April 2021 PDF (3.8 M) | ||
| DOI: 10.4103/ejs.ejs_60_21 | ||
| Authors | ||
| Mohamed S. Khalifa; Mohammed A. Hamed; Amr M.M. Elhefny | ||
| Abstract | ||
| Background Large/giant peptic ulcer (duodenal ulcer and benign gastric ulcer) perforation is a serious life-threatening surgical emergency, with high morbidity and mortality rates. Despite that, no single surgical approach has yet been shown to be superior to others. Patients and methods This is a prospective randomized study comparing the efficacy of omental plugging, duodenal exclusion, and jejunal serosal patch as different alternating operative techniques in managing such a problem. Results Thirty patients with large/giant peptic perforation more than 2 cm in diameter were included over a period of 24 months. Patients were divided into three groups (A, B, and C) according to surgical approach applied. Males/females were 27/3, average age was 45–73 years old, and mean operative time was 75±28.4 min. Biliary leak rates were 3.3, 10, and 6.6% in group A (omental plug), group B (jejunal serosal patch), and group C (duodenal exclusion and gastrojejunostomy), respectively, with value of 0.199. Conclusion The management of large/giant peptic (duodenal ulcer and gastric ulcer) perforations is difficult and presents a great challenge to surgeons. Duodenal stump leaks can carry high incidence of morbidity and mortality. Multiple surgical modalities are available to deal with such surgical problems. | ||
| Keywords | ||
| duodenal exclusion and gastrojejunostomy; giant peptic ulceration; jejunal serosal patch; omental plugging | ||
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