scholarly journals Potential use of peptic ulcer perforation (PULP) score as a conversion index of laparoscopic-perforated peptic ulcer (PPU) repair

2020 ◽  
Author(s):  
Yu-Hao Wang ◽  
Yu-Tung Wu ◽  
Chih-Yuan Fu ◽  
Chien-Hung Liao ◽  
Chi-Tung Cheng ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Area Under The Curve ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcer Perforation ◽  
Patient Demographics ◽  
Operative Findings ◽  
Intraoperative Conversion ◽  
Potential Use ◽  
Preoperative Factors

Abstract Background Laparoscopic repair is a well-accepted treatment modality for perforated peptic ulcer (PPU). However, intraoperative conversion to laparotomy is still not uncommon. We aimed to identify preoperative factors strongly associated with conversion. Methods A retrospective review of records of all PPU patients treated between January 2011 and July 2019 was performed. Patients were divided into three groups: laparoscopic repair (LR), conversion to laparotomy (CL), and primary laparotomy (PL). Patient demographics, operative findings, and outcomes were compared between the groups. Logistic regression analyses were performed, taking conversion as the outcome. Results Of 822 patients, there were 236, 45, and 541 in the LR, CL, and PL groups, respectively. The conversion rate was 16%. Compared with those in the LR group, patients in the CL group were older (p < 0.001), had higher PULP scores (p < 0.001), had higher ASA scores (p < 0.001) and had hypertension (p = 0.003). PULP score was the only independent risk factor for conversion. The area under the curve (AUC) for the PULP score to predict conversion was 75.3%, with a best cut-off value of ≥ 4. The operative time was shorter for PL group patients than for CL group patients with PULP scores ≥ 4. For patients with PULP scores < 4, LR group patients had a shorter length of stay than PL group patients. Conclusion The PULP score may have utility in predicting and minimizing conversion for laparoscopic PPU repair. Laparoscopic repair is the procedure of choice for PPU patients with PULP scores < 4, while open surgery is recommended for those with PULP scores ≥ 4.

scholarly journals Laparoscopic Repair of Peptic Ulcer Perforation - Our Initial Experience

2014 ◽  
Vol 1 (2) ◽  
pp. 153-157
Author(s):  
Md. Saiful Hoque ◽  
Gazi Mohammad Zakir Hossain ◽  
Nur Hossain Bhuiyan ◽  
Md. Rashedul Hasan ◽  
Mayin Uddin Mahmud ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Laparoscopic Repair ◽  
Operation Time ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcer Perforation ◽  
Related Complication ◽  
Ulcer Perforation ◽  
Delayed Recovery ◽  
Duodenal Ulcer Perforation

Background: Laparoscopic repair of perforated peptic ulcer was reported in 1990 but has not gained wide acceptance. The aim of this study was to evaluate the safety and efficacy of laparoscopic repair in routine clinical practice.Methods: This was a prospective analysis of 30 patients who underwent laparoscopic repair of a perforated peptic ulcer between July 2009 and June2010.Results: Thirty patients of mean age 45 (range 25-52) years had perforated ulcer diagnosed by clinical examination and x-ray abdomen and confirmed by laparoscopy. 28 was duodenal ulcer perforation and rest 2 was gastric ulcer perforation. Only 3 patients required conversion to laparotomy out of them 2 were DU perforation and one was gastric ulcer perforation. Mean operation time was 75 (range 75-150) minutes. Mean postoperative hospital stay was 6 (5-10) days. Postoperative convalescences were good. There was no operation related complication but one patient needs transfer to ICU for delayed recovery and the patient eventually recovered well. Post-operative leakage occurred in one patient and that was treated by laparotomy. One of 3 conversion cases developed wound infection but wound related complications in laparoscopic cases were very negligibe.Conclusion: Laparoscopic repair is a safe and effective procedure for repair of perforated peptic ulcer.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19535

scholarly journals Laparoscopic Repair for Perforated Peptic Ulcer

2002 ◽  
Vol 235 (3) ◽  
pp. 313-319 ◽  
Author(s):  
Wing T. Siu ◽  
Heng T. Leong ◽  
Bonita K. B. Law ◽  
Chun H. Chau ◽  
Anthony C. N. Li ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer

Laparoscopic Repair of Perforated Peptic Ulcer in the Elderly

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pietro Fransvea ◽  
Gianluca Costa ◽  
Luca Lepre ◽  
Mauro Podda ◽  
Alessio Giordano ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer ◽  
The Elderly

scholarly journals Association of Helicobacter Pylori with Peptic Ulcer Perforation

2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Peptic Ulcer Perforation ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

scholarly journals Laparoscopic Repair for Perforated Duodenal Ulcer

2015 ◽  
Vol 20 (3) ◽  
pp. 168-172
Author(s):  
Cotirleţ A. ◽  
Tincu E. ◽  
Coşa Raluca ◽  
Popa E. ◽  
Gavril Laura ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer ◽  
Gastric Surgery ◽  
High Morbidity ◽  
Ulcer Disease ◽  
Surgical Emergencies ◽  
Abdominal Disease ◽  
Laparoscopic Closure ◽  
Prolonged Surgery

Abstract Perforated peptic ulcer (PPU), despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies but there is no consensus on whether the benefits of laparoscopic closure of perforated peptic ulcer outweigh the disadvantages such as prolonged surgery time and greater expense. However we can say that laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered with the necessary expertise available.

Open Versus Laparoscopic Repair of Perforated Peptic Ulcer Disease

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Peter O. Coe ◽  
Matthew J. Lee ◽  
Hannah Boyd-Carson ◽  
Sonia Lockwood ◽  
Arin Saha
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer ◽  
Ulcer Disease ◽  
Open Versus

Selection of patients for laparoscopic repair of perforated peptic ulcer

2001 ◽  
Vol 88 (1) ◽  
pp. 133-136 ◽  
Author(s):  
F. Y. J. Lee ◽  
K. L. Leung ◽  
P. B. S. Lai ◽  
J. W. Y. Lau
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer ◽  
Selection Of Patients ◽  
Selection Of
Sign in / Sign up

Export Citation Format

Share Document