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Role of laparoscopic surgery for management of duodenal ulcer perforation

Amit H Joshi, Pratik H Vyas, Jaimini Jayswal.

Abstract
Background: The chief support of remedy of patients with peptic duodenal perforation is surgery. With the invention of minimal access procedures, laparoscopy is being used for the treatment of this condition.

Objective: To establish the role of laparoscopy in duodenal ulcer perforation.

Materials and Methods: This is a nonrandomized, controlled clinical trial. Patients diagnosed with perforated peptic ulcers, admitted to VS Hospital during the period of January 2013–June 2014, underwent either open or laparoscopic suture omental patch repair. A total of 20 patients were included in the study; 10 in laparoscopic group and 10 in open group.

Result: This observational study revealed 80% male preponderance, and 57% of them were in the fourth, fifth, and sixth decades, with mean age of 50 years. The duration of surgery was 56 min in open group when compared with 76 min in laparoscopic group. The duration of antibiotic usage in open group was 5 days when compared with 3 days in laparoscopic group. The usage of analgesics in open group was 7 days when compared with 5 days in laparoscopic group. The hospital stay for open surgery was 8 days when compared with 6 days in laparoscopic group. There were wound infections in three patients in open group when compared with one in laparoscopic group. No leakage was reported in either group. Two patients in laparoscopic group needed conversion.

Conclusion: Results of laparoscopic management of perforated peptic ulcer are encouraging, with no conversion to open surgery, low morbidity, and no mortality.

Key words: Laparoscopy, peritonitis, duodenal ulcer perforation



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