Laparoscopic and Open Surgical Treatment in Gastroduodenal Perforations: Our Experience

Laforgia, Rita; Balducci, Giovanni; Carbotta, Giuseppe; Prestera, Antonio; Sederino, Maria Grazia; Casamassima, Giulia; Minafra, Marina; Sallustio, Pierluca Nicola Massimo; Palasciano, Nicola

doi:10.1097/sle.0000000000000376

Cited by 20 publications

(23 citation statements)

References 9 publications

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“…After irrigation of the peritoneal cavity, two closed suction drains were inserted along the pelvic cavity and right subhepatic space. Postoperative management and follow-up did not deviate significantly from those reported in other studies (14,15).…”

Section: Operative Procedures In Group Asupporting

confidence: 43%

Duet laparoscopic repair with knotless barbed sutures for treatment of perforated peptic ulcer: reality in general surgery with lacking of manpower

2021

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Background: Perforated peptic ulcer (PPU) is a fatal complication of peptic ulcer disease, which requires emergency surgery. Laparoscopic repair is the widely accepted and effective method for the treatment of PPU. The aim of this study was to evaluate the safety and efficacy of duet laparoscopic repair of PPU with knotless barbed sutures.Methods: From January 2013 to May 2019, 40 patients with PPU underwent laparoscopic primary repair and omentopexy at the Dankook University Hospital. The operative outcomes and complications of patients undergoing surgery using continuous suturing with absorbable knotless barbed sutures (group A, n=15) were compared with those undergoing surgery with conventional interrupted sutures (group B, n=25). Results:The mean operative time was significantly shorter in group A than group B (84.4±39.8 vs.104.2±49.4 min, P<0.001). There were no differences in other operative outcomes or postoperative complications (group A vs. group B, 20.0% vs. 24.0%, respectively; P=0.249) between the two groups. The mean operation time spent for laparoscopic sutures and omentopexy was 22.7 minutes. Conclusions:The findings of the current study, albeit performed retrospectively at a single institution, suggested that duet laparoscopic repair of PPU with knotless barbed sutures might be considered as an alternative option, especially in hospitals lacking manpower.

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Section: Operative Procedures In Group Asupporting

confidence: 43%

Duet laparoscopic repair with knotless barbed sutures for treatment of perforated peptic ulcer: reality in general surgery with lacking of manpower

2021

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“…Some studies confirm that the use of laparoscopic repair for the treatment of perforated peptic ulcers remains controversial due to the concerns related to a longer operation time, leak and the high rate of reoperation [21], which was not observed in our study. Other studies on laparoscopic repair of perforated peptic ulcer have shown that this method is more favorable than the open repair method as it involves less analgesic therapy, has a shorter hospital stay, a lower rate of wound infection, a lower mortality rate and earlier return to work [22, 38, 39]. The limiting factor in laparoscopic repair of perforated peptic ulcer is the lack of availability of expertise and competency of the surgeon [28, 40].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and open repair for perforated duodenal ulcer: single-center experience.

Stepanyan

Petrosyan

Safaryan

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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IntroductionPerforation is a dangerous complication of peptic ulcer disease and requires emergency surgical treatment. In recent decades laparoscopic repair of duodenal perforation has been widely used in emergency abdominal surgery.AimTo analyze laparoscopic and open surgical treatment of 120 consecutive patients with perforated duodenal ulcer.Material and methodsThe study included a group of 120 consecutive patients, operated on for perforated duodenal ulcer in a single institution. Laparoscopic or open repair with or without an omental patch was performed. The value of the Boey score was investigated in predicting the outcomes of treatment in the entire study group.ResultsIn 61 (50.8%) cases open repair was performed, in 56 (46.7%) cases laparoscopic repair, and in 3 (2.5%) cases conversion was performed. In the laparoscopy group the mean hospital stay was 5 days (range: 3–14), in the open group 11.7 days (range: 6–63), and in the conversion group 9.3 days (8–10) (p < 0.001). There was a significant difference between characteristics of patients in the laparoscopic groups: in the second period of laparoscopic procedures (2014–2017) the duration of the operation was significantly shorter and the number of postoperative complications was significantly lower than in the initial study group (2010–2013).ConclusionsThe laparoscopic approach is an effective method for treatment of perforated duodenal ulcer in selected cases. A number of 20–25 cases for the surgeon operating with the laparoscopic method is sufficient to achieve an acceptable level of expertise. More prospective randomized studies are needed to evaluate the effectiveness of laparoscopic repair of perforated duodenal ulcer.

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“…Patient selection criteria and exclusion Most studies included patients based on their symptoms and diagnosis of a perforated peptic ulcer. Only a few of them included patients regardless of their comorbidities or severity of their affliction [7], [8].…”

Section: Resultsmentioning

confidence: 99%

Is Laparoscopic Surgery Becoming the First Choice in Treatment of Perforated Peptic Ulcer?

Popa

Mușat

Păduraru

et al. 2020

RoJES

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Perforated peptic ulcer (PPU), a significant complication of peptic ulcer disease, has proven to be associated with high rates of mortality and morbidity and to this day, it remains a clear indication of emergency surgery. Whilst open repair remains a feasible treatment option for this complication, the development of laparoscopic surgery has brought along new perspectives, by revealing the benefits and drawbacks of this procedure and therefore raising the question whether it should be the first choice in treatment of a PPU. A literature search was performed using PubMed, Web of Science and Scopus, with the selection of relevant articles from the last 15 years. By comparing the two surgical approaches, conventional and laparoscopic, we aimed to identify the reasons laparoscopy is gaining ground as a mean of treatment of a PPU. Outcomes such as hospital stay, complication rates, use of postoperative analgesics and visual analogue scale favored laparoscopy. The most heterogeneous result was dictated by the operation time, which seems to correlate with multiple factors, a major one being the learning curve and skills this procedure requires. In addition, a significant number of papers had developed patient inclusion and exclusion criteria, which impacted the results of outcomes like morbidity and mortality. There is a lot of evidence that points to laparoscopy becoming the preferred method of treatment of a PPU, however further research is needed in order to reach a consensus.

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Laparoscopic and Open Surgical Treatment in Gastroduodenal Perforations: Our Experience

Cited by 20 publications

References 9 publications

Duet laparoscopic repair with knotless barbed sutures for treatment of perforated peptic ulcer: reality in general surgery with lacking of manpower

Duet laparoscopic repair with knotless barbed sutures for treatment of perforated peptic ulcer: reality in general surgery with lacking of manpower

Laparoscopic and open repair for perforated duodenal ulcer: single-center experience.

Is Laparoscopic Surgery Becoming the First Choice in Treatment of Perforated Peptic Ulcer?

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