Novel approach for peptic ulcer perforation surgery

Ahmadinejad, Mojtaba; Maghsoudi, Leila Haji

doi:10.1002/ccr3.3030

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…Questions related to the management of a PUP were as follows [ 1 ]: Is surgery indicated? [ 2 ] Is an omental patch indicated as sufficient for ulcer operation ? [ 3 ] Is the patient able enough to undergo surgery?…”

Section: Discussionmentioning

confidence: 99%

“…However, the omentum of thin or elderly patients may be very attenuated or virtually non-existent. However, in some select patients where the greater omentum is either unviable, unhealthy, or cannot be utilized, the falciform ligament can be used as an adequate patch for closure [ 2 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Peptic ulcer perforation (PUP) is one of the most common surgical emergencies worldwide, and surgery should be performed as soon as possible. The overall mortality rate of PUPs is between 1.3% and 20%, and mortality due to a perforation of a stomach ulcer is higher than mortality due to a perforation of a duodenal ulcer (40% vs 10%) [ 2 , 3 ]. Some studies have shown that having comorbidities, being over 70 years old, undergoing surgical treatment after 36 h, PUP diameter greater than 1 cm 2 and postoperative complications are related to mortality [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the greater omentum cannot be used in cases of severe peritonitis or previous surgical removal. On the other hand, dilated small intestine and colon due to peritonitis and abdominal distention cause omentum stretch, which results in a high (8) risk of punctures and leaks [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: A cross-sectional study at a single centre in Vietnam

Sơn

Học

Hương

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Peptic ulcer perforation (PUP) is one of the most common critical surgical emergencies. The omentum flap is commonly used to cover a PUP. However, the omentum cannot be used in cases of severe peritonitis or previous surgical removal. This is the first study conducted in Vietnam that was designed to analyse the outcomes of patients with PUPs who were treated using the falciform ligament. Method In this study, we retrospectively identified 40 consecutive patients who were treated for PUP at a single high-volume centre in Vietnam from February 2018 to February 2021. Peptic ulcer perforation was measured during diagnostic evaluation based on preoperative imaging, such as X-ray, and CT scan. Patients who had malignancy, laparoscopic surgery, omentopexy and nonoperative treatment were excluded from this research. Results Forty patients were included; the mean age of the patients was 66.3 years (range 33–99 years), and some patients had comorbid disease (57.5%), hypertension (30%), diabetes (10%), cirrhosis (7.5%), and chronic renal failure (7.5%). The PUPs were located in the duodenum (80%), or the pyloric (15%) and prepyloric (5%) regions. The procedures used to treat the patients included duodenostomy (32.5%), gastrojejunostomy (37.5%), and antrum resection (2.5%). The average operative time was 88.6 min (45–180 min), hospital stay was 9.6 days (2–35 days), and oral intake was started at 4.1 days (3–8 days); additionally, the 30-day mortality (17.5%) and incidences of pneumonia (25%), multiorgan failure (15%), acute liver failure (5%), wound infection (7.5%), and ulcer peptic fistula (0%) were assessed. Univariate tests showed that an ASA ≥ III and comorbidities, such as pulmonary complications, liver failure and multiorgan failure, were associated with mortality. The multivariate test showed that multiorgan failure was the only factor related to mortality. Conclusion The falciform ligament can be efficiently used for the closure of a PUP. Although there were no instances of complication with a reperforated peptic ulcer, the mortality rate was slightly highly related to severe comorbidities and postoperative multiorgan failure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: A cross-sectional study at a single centre in Vietnam

Sơn

Học

Hương

et al. 2021

Annals of Medicine &Amp; Surgery

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“…Twelve studies reported use of falciform ligament in gastrointestinal surgery with most common technique employing falciform ligament in perforated gastric or intestinal ulcer as an alternative to graham patch. 1,[6][7][8][9][10][11] A total of 14 patients underwent falciform ligament for intestinal perforation. No mortalities were reported, and no studies reported technical complications or unplanned returns to the operating room.…”

Section: Gastrointestinal Surgerymentioning

confidence: 99%

Utility of Falciform Ligament in Abdominal Surgery: A Systematic Review

Liu

Saber

2022

The American Surgeon™

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Objective The aim of the present systematic review was to assess current trends in use of falciform ligament in abdominal surgery. Background The falciform ligament has been proposed in surgical literature as a suitable pedicle or flap with acceptable surgical outcomes; however, it is underutilized in abdominal surgery. Methods We performed a literature search and meta-analysis. All English studies describing use of a falciform ligament were eligible for inclusion. Results Of the 547 articles mentioning use of falciform ligament, 32 full text articles were included in this review. The majority were case reports (n = 14). The mremaining papers included retrospective analysis (n = 10), randomized control trials (n = 2), reviews (n = 3), and technique descriptions (n = 6). Conclusion The falciform ligament appears to be a safe and easily accessible natural tissue with a variety of surgical applications. It is most useful as a pedicle flap and could have benefit in foregut surgery including hepatic, pancreatic, biliary, gastric, and esophageal operations.

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Cross-sectional study on hearing loss and auditory reaction time before and after spinal anesthesia with marcaine 0.5% in patients undergoing elective surgery

Vahabi

Veiskarami

Roozbahani

et al. 2020

Annals of Medicine and Surgery

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Novel approach for peptic ulcer perforation surgery

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 10 publications

References 6 publications

Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: A cross-sectional study at a single centre in Vietnam

Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: A cross-sectional study at a single centre in Vietnam

Utility of Falciform Ligament in Abdominal Surgery: A Systematic Review

Cross-sectional study on hearing loss and auditory reaction time before and after spinal anesthesia with marcaine 0.5% in patients undergoing elective surgery

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