COMPARISON BETWEEN LAPAROSCOPIC AND OPEN REPAIR OF PERFORATED DUODENAL ULCER; A RETROSPECTIVE NONRANDOMIZED CONTROLLED TRIAL | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 31, Issue 4, October 2012, Page 175-180 PDF (546.47 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2012.367253 | ||||
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| Authors | ||||
| Omar Abdelraheem1; Magdy Khalil* 1; Ahmed Eisa1; Tarek Talaat2 | ||||
| 1Departments of General Surgery, Faculty of Medicine, Sohag University, Egypt | ||||
| 2Pediatric Surgery, Faculty of Medicine, Sohag University, Egypt | ||||
| Abstract | ||||
| Background: Perforation is a common and serious complication of peptic ulcer disease that requires urgent surgical interference .Our aim is to evaluate the effectiveness and postoperative outcome of laparoscopic procedure in repairing perforated duodenal ulcers by comparing this modality with the conventional open surgical repair. Patients and Methods: A retrospective study of 58 concecutive cases were included and subjected to simple closure of the perforated duodenal ulcers from May 2009 to January 2012 at Sohag University Hospital. Twenty two patients were managed laparoscopically and 36 patients underwent open surgical repair. Demographic data and surgical outcome were compared in both groups. Results: The operative time in laparoscopic group is more than open group, but without significant statistical difference (p=0.126). Laparoscopic group showed an earlier tolerance to oral feeding (4.26 ± 0.42 vs 5.12± 2.38 days, p=0.04). Additionally, laparoscopic group showed an earlier hospital discharge and return to work than open one (6.63 ± 1.92 vs. 8.24±2.32 days, p=0.026, 20.28 ± 0.16 vs 28.23 ± 0.87 days, p=0.041, respectively). The mean consumed postoperative analgesics per day was less among laparoscopic group (1.7 ± 0.26 vs 3.1 ± 0.34 ampoule/day, p=0.013). The incidence of wound infection, wound dehiscence, prolonged ileus and postoperative pneumonia were more in open group. There were no mortalities in laparoscopic group, but two cases died in open one. Intra-operative conversion to open surgery in laparoscopic group was performed to four cases. Conclusions: Laparoscopic primary repair of perforated peptic ulcer can be done safely in early cases. It offers less postoperative pain, low incidence of postoperative wound complications , early hospital discharge and return to work, in addition to the cosmetically better outcome. Further training in laparoscopic skills is needed to propose it as a standard method for repair of perforated duodenal ulcers. | ||||
| Keywords | ||||
| Laparoscopy; duodenal ulcer; perforation | ||||
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