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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2019
vol. 14
 
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abstract:
Original paper

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

Suren Agho Stepanyan, Areg Artak Petrosyan, Hayk Hovhannes Safaryan, Hayk Henrik Yeghiazaryan, Andranik Yuri Aleksanyan, Vahe Mkrtich Hakobyan, Karen Tigran Papazyan, Mkrtich Hamlet Mkrtchyan

Videosurgery Miniinv 2019; 14 (1): 60–69
Online publish date: 2018/06/11
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Introduction
Perforation 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.

Aim
To analyze laparoscopic and open surgical treatment of 120 consecutive patients with perforated duodenal ulcer.

Material and methods
The 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.

Results
In 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).

Conclusions
The 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.

keywords:

laparoscopic surgery, peptic ulcer, peptic ulcer perforation

references:
Zimmermann M, Wellnitz T, Laubert T, et al. Gastric and duodenal perforations: what is the role of laparoscopic surgery? Zentralbl Chir 2014; 139: 72-8.
Thorsen K, Soreide J.A, Kvaloy JT, et al. Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality. World J Gastroenterol 2013; 19: 347-54.
Sarosi GA, Jaiswal KR, Nwariaku FE, et al. Surgical therapy of peptic ulcers in the 21st century: more common than you think. Am J Surg 2005; 190: 775-9.
Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010; 27: 161-9.
Siu WT, Leong HT, Li MK. Single stitch laparoscopic omental patch repair of perforated peptic ulcer. J R Coll Surg Edinb 1997; 42: 2-4.
Møller MH, Adamsen S, Wojdemann M, et al. Perforated peptic ulcer: how to improve outcome? Scand J Gastroenterol 2009; 44: 15-22.
Kashiwagi H. Ulcer and gastritis. Endoscopy 2007; 39: 101-5.
Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment, and prognosis. World J Surg 2000; 24: 277-83.
Thorsen K, Glomsaker T.B, von Meer A, et al. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. J Gastrointest Surg 2011; 15: 1329-35.
Imhof M, Epstein S, Ohmann C, et al. Duration of survival after peptic ulcer perforation. World J Surg 2008; 32: 408-12.
Bonin EA, Moran E, Gostout CJ, et al. Natural orifice transluminal endoscopic surgery for patients with perforated peptic ulcer. Surg Endosc 2012; 26: 1534-8.
Guadagni S, Cengeli I, Galatioto C, et al. Laparoscopic repair of perforated peptic ulcer: single-center results. Surg Endosc 2014; 28: 2302-8.
Mouly C, Chati R, Scotté M, et al. Therapeutic management of perforated gastro-duodenal ulcer: literature review. J Visc Surg 2013; 150: 333-40.
Aljohari H, Althani H, Elmabrok G, et al. Outcome of laparoscopic repair of perforated duodenal ulcers. Singapore Med J 2013; 54: 216-9.
Palanivelu C, Jani K, Senthilnathan P. Laparoscopic management of duodenal ulcer perforation: is it advantageous? Indian J Gastroenterol 2007; 26: 64-6.
Kim JH, Chin HM, Bae YJ, et al. Risk factors associated with conversion of laparoscopic simple closure in perforated duodenal ulcer. Int J Surg 2015; 15: 40-4.
Søreide K, Thorsen K, Søreide JA. Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg 2014; 101: 51-64.
Byrge N, Barton RG, Enniss TM, et al. Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis. Am J Surg 2013; 206: 957-63.
Nathanson LK, Easter DW, Cuschieri A. Laparoscopic repair/ peritoneal toilet of perforated duodenal ulcer. Surg Endosc 1990; 4: 232-3.
Mouret P, Francois Y, Vignal J, et al. Laparoscopic treatment of perforated peptic ulcer. Br J Surg 1990; 77: 1006.
Law WY, Leung KL, Zhu XL, et al. Laparoscopic repair of perforated peptic ulcer. Br J Surg 1995; 82: 814-6.
Lunevicius R, Morkevicius M. Comparison of laparoscopic versus open repair for perforated duodenal ulcers. Surg Endosc 2005; 19: 1565-71.
Minutolo V, Gagliano G, Rinzivillo C, et al. Laparoscopic surgical treatment of perforated duodenal ulcer. Chir Ital 2009; 61: 309-13.
Bornman PC, Theodorou NA, Jeffery PC. Simple closure of perforated duodenal ulcer: a prospective evaluation of a conservative management policy. Br J Surg 1990; 77: 73-5.
Turner WT, Thompson WM, Thal ER. Perforated gastric ulcers. A plea for management by simple closure. Arch Surg 1988; 123: 960-4.
Collier D, Pain JA. Perforated peptic ulcers. J R Coll Surg Edinb 1985; 30: 26-9.
Mitura K, Skolimowska-Rzewuska M, Garnysz K. Outcomes of bridging versus mesh augmentation in laparoscopic repair of small and medium midline ventral hernias. Surg Endosc 2017; 31: 382-8.
Siu WT, Leong HT, Law BK, et al. Laparoscopic repair for perforated peptic ulcer. Ann Surg 2002; 235: 313-9.
Durai R, Razvi A, Uzkalnis A, et al. Duodenal ulcer perforation: a district hospital experience. Acta Chir Belg 2011; 111: 23-5.
Sartelli M, Viale P, Catena F, et al. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg 2013; 8: 3.
Arnaud JP, Tuech JJ, Bergamaschi R, et al. Laparoscopic suture closure of perforated duodenal peptic ulcer. Surg Laparosc Endosc Percutan Tech 2002; 12: 145-7.
Sommer T, Elbroend H, Friis-Andersen H. Laparoscopic repair of perforated ulcer in Western Denmark – a retrospective study. Scand J Surg 2010; 99: 119-21.
Thorsen K, Søreide JA, Søreide K. Scoring systems for outcome prediction in patients with perforated peptic ulcer. Scand J Trauma Resusc Emerg Med 2013; 21: 25.
Lohsiriwat V, Prapasrivorakul S, Lohsiriwat D. Perforated peptic ulcer: clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. World J Surg 2009; 33: 80-5.
Boey J, Choi SK, Poon A, et al. Risk stratification in perforated duodenal ulcers. A prospective validation of predictive factors. Ann Surg 1987; 205: 22-6.
Lo HC, Wu SC, Huang HC, et al. Laparoscopic simple closure alone is adequate for low risk patients with perforated peptic ulcer. World J Surg 2011; 35: 1873-8.
Kok KY, Mathew VV, Yapp SK. Laparoscopic omental patch repair for perforated duodenal ulcer. Am Surg 1999; 65: 27-30.
Lau H. Laparoscopic repair of perforated peptic ulcer: a meta-analysis. Surg Endosc 2004; 18: 1013-21.
Laforgia R, Balducci G, Carbotta G, et al. Laparoscopic and open surgical treatment in gastroduodenal perforations: our experience. Surg Laparosc Endosc Percutan Techn 2017; 27: 113-5.
Grišin E, Mikalauskas S, Poškus T, et al. Laparoscopic pyloroplasty for perforated peptic ulcer: case report. Videosurgery Miniinv 2017; 12: 311-4.
  
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