A Randomized Study Comparing Laparoscopic Versus Open Repair of Perforated Peptic Ulcer Using Suture or Sutureless Technique

Lau, W. Y.; Leung, Aaron Kam-Lun; Kwong, Karen L.; Davey, I. C.; Robertson, Charles; Dawson, Jonathan J. W.; Chung, S. C. S.; Li, Arthur K.C.

doi:10.1097/00000658-199608000-00004

Cited by 280 publications

(291 citation statements)

References 13 publications

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“…Peptic ulcer perforation is a serious complication which affects almost 10 % of PUD patients. Overall, PUD accounts for more than 70 % of mortality associated with the disease [3,4] . Several potential predicting factors for perforation have been evaluated in the literature, including use of ulcerogenic drugs (e.g.…”

Section: Introductionmentioning

confidence: 99%

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Testini¹,

Portincasa

Piccinni

et al. 2003

WJG

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AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications, and intra-abdominal and/or wound infections), serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0 %. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission, postoperative abdominal complications and/or wound infections, were significantly associated (χ 2

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Section: Introductionmentioning

confidence: 99%

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Testini¹,

Portincasa

Piccinni

et al. 2003

WJG

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“…After surgery patients in laparoscopic group required significantly less parenteral analgesics than those who underwent open repair (1.2 days in group 1 vs 3.8 in Group 2, p>0.05) which is statistically significant. The Meta analysis published by Lau showed that eight out of 10 studies showed significant reduction in dosage of analgesics required in laparoscopic group [3,5]. Mean duration of resumption of normal diet was 2.4 with laparoscopic repair and 3.6 with laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Versus Open Repair in Management of Peptic Perforation Peritonitis: A Comparative Analysis

Kuswaha¹,

Rabari²,

Bhadania³

2017

IJABMS

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Introduction: Despite the widespread use of antisecretory agents and eradication therapy, the incidence of perforated peptic ulcer has changed little. Since the initial reports of successful laparoscopic management of perforated duodenal ulcers and perforation peritonitis several larger comparative series have been published confirming the technical feasibility and advantages of laparoscopic approach. Objectives:The aim is to compare the outcome and efficacy of laparoscopic repair with conventional laparotomy in the management of peptic perforation. Methods: The study was conducted on patients with diagnosis of peptic perforation in V.S. Hospital, Ahmedabad. It is a retrospective study from August 2014 to November 2016. Result: 50 patients of perforation peritonitis were operated randomly by laparoscopic repair and laparotomy. It was found that the laparoscopic repair of perforated peptic ulcer was associated with less intra operative blood loss, no intraoperative and postoperative complications, minimum postoperative pain which was significant as compared to laparotomy repair. Conclusion: Laparoscopic repair of perforated peptic ulcer could be considered as a good alternative for open repair in routine clinical practice in the management of peptic perforation peritonitis as less intraoperative blood loss, less postoperative pain and better cosmesis.

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“…The increase in operative time is considered to be a risk factor for increased post-operative complications [24]. There is a constant effort to simplify the suturing technique, and this has evolved from the traditional omental plug or omentoplasty to simple suturing [27], clips [31] or suture less technique with sealants [32]. It remains to be seen whether this effort to reduce operating time is associated with increased risk of complications, i.e.…”

Section: Perforated Peptic Ulcermentioning

confidence: 99%

“…Wadaani in his prospective case series of 45 patients (2013) has used the irrigation selectively in cases with visible food remnants in peritoneal cavity, and this has been postulated as an independent factor in reducing the operative time [33]. Due to improving surgical skills, technology and better teamwork, a progressive reduction in operative times [94 min (Lau et al 1996), 75 min (Bertleff et al 2009) and 42 min (Wadaani 2013)] has been achieved in the past years [8].…”

Section: Perforated Peptic Ulcermentioning

confidence: 99%

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

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A Randomized Study Comparing Laparoscopic Versus Open Repair of Perforated Peptic Ulcer Using Suture or Sutureless Technique

Abstract: ObjectiveThis study compares laparoscopic versus open repair and suture versus sutureless repair of perforated duodenal and juxtapyloric ulcers.

Cited by 280 publications

References 13 publications

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Laparoscopic Versus Open Repair in Management of Peptic Perforation Peritonitis: A Comparative Analysis

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

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