scholarly journals Laparoscopic versus Open Omental Patch Repair for Early Presentation of Perforated Peptic Ulcer: Matched Retrospective Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Daniel Jin Keat Lee ◽  
MaDong Ye ◽  
Keith Haozhe Sun ◽  
Vishalkumar G. Shelat ◽  
Aaryan Koura
Keyword(s):  
Peptic Ulcer ◽  
Outcome Measures ◽  
Statistical Significance ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Early Presentation ◽  
Omental Patch ◽  
Or Groups

Introduction.The aim of this study was to compare the outcomes between laparoscopic and open omental patch repair (LOPR versus OR) in patients with similar presentation of perforated peptic ulcer (PPU). The secondary aim was to evaluate the outcomes according to the severity of peritonitis.Methods.All patients who underwent omental patch repair at two university-affiliated institutes between January 2010 and December 2014 were reviewed. Matched cohort between LOPR and OR groups was achieved by only including patients that had ulcer perforation <2 cm in size and symptoms occurring <48 hours. Outcome measures were defined in accordance with length of stay (LOS), postoperative complications, and mortality.Results.148 patients met the predefined inclusion criteria with LOPR performed in 40 patients. Outcome measures consistently support laparoscopic approach but only length of hospital stay (LOS) achieved statistical significance (LOPR 4 days versus OR 5 days,p<0.01). In a subgroup analysis of patients with MPI score >21, LOPR is also shown to benefit, particularly resulting in significant shorter LOS (4 days versus 11 days,p<0.01).Conclusion.LOPR offers improved short-term outcomes in patients who present within 48 hours and with perforation size <2 cm. LOPR also proved to be more beneficial in high MPI cases.

Routine laparoscopic single-stitch omental patch repair for perforated peptic ulcer: experience from 338 cases

2008 ◽  
Vol 23 (2) ◽  
pp. 457-458 ◽  
Author(s):  
D. C. T. Wong ◽  
W. T. Siu ◽  
S. K. H. Wong ◽  
Y. P. Tai ◽  
M. K. W. Li
Keyword(s):  
Peptic Ulcer ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Omental Patch

scholarly journals Strict Selection Criteria During Surgical Training Ensures Good Outcomes in Laparoscopic Omental Patch Repair (LOPR) for Perforated Peptic Ulcer (PPU)

2015 ◽  
Vol 100 (2) ◽  
pp. 370-375 ◽  
Author(s):  
Vishal G. Shelat ◽  
Saleem Ahmed ◽  
Clement L. K. Chia ◽  
Yee Lee Cheah
Keyword(s):  
Peptic Ulcer ◽  
Acute Care ◽  
Selection Criteria ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Perioperative Outcomes ◽  
Omental Patch ◽  
Severity Scores ◽  
Care Surgery ◽  
Strict Selection

Application of minimal access surgery in acute care surgery is limited due to various reasons. Laparoscopic omental patch repair (LOPR) for perforated peptic ulcer (PPU) surgery is safe and feasible but not widely implemented. We report our early experience of LOPR with emphasis on strict selection criteria. This is a descriptive study of all patients operated on for PPU at academic university-affiliated institutes from December 2010 to February 2012. All the patients who were operated on for LOPR were included as the study population and their records were studied. Perioperative outcomes, Boey score, Mannheim Peritonitis Index (MPI), and physiologic and operative severity scores for enumeration of mortality and morbidity (POSSUM) scores were calculated. All the data were tabulated in a Microsoft Excel spreadsheet and analyzed using Stata Version 8.x. (StataCorp, College Station, TX, USA). Fourteen patients had LOPR out of a total of 45 patients operated for the PPU. Mean age was 46 years (range 22−87 years). Twelve patients (86%) had a Boey score of 0 and all patients had MPI &lt; 21 (mean MPI = 14). The predicted POSSUM morbidity and mortality were 36% and 7%, respectively. Mean ulcer size was 5 mm (range 2−10 mm), mean operating time was 100 minutes (range 70−123 minutes) and mean length of hospital stay was 4 days (range 3−6 days). There was no morbidity or mortality pertaining to LOPR. LOPR should be offered by acute care surgical teams when local expertise is available. This can optimize patient outcomes when strict selection criteria are applied.

scholarly journals Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
André Pereira ◽  
Hugo Santos Sousa ◽  
Diana Gonçalves ◽  
Eduardo Lima da Costa ◽  
André Costa Pinho ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hospital Stay ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Perforated Peptic Ulcer ◽  
Open Group ◽  
New Paradigm ◽  
Female Ratio

Introduction. Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. Methods. Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. Results. During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; p = 0.009 ) and in the presence of sepsis criteria (12.2% versus 38.3%, respectively; p = 0.001 ), while the Boey score showed no differences between the two groups. The operative time was longer in the laparoscopic group (median 100’ versus 80’, p = 0.01 ). Laparoscopy was associated with few early postoperative complications (18.4% versus 41.7%, p = 0.004 ), mortality (2.0% versus 14.2%; p = 0.02 ), shorter hospital stay (median 6 versus 7 days, p = 0.001 ), and earlier oral intake (median 3 versus 4 days, p = 0.021 ). Conclusion. Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.

scholarly journals Laparoscopic Omental Patch Repair for Perforated Peptic Ulcer

1995 ◽  
Vol 221 (3) ◽  
pp. 236-240 ◽  
Author(s):  
Masao Matsuda ◽  
Motoharu Nishiyama ◽  
Tsunekazu Hanai ◽  
Satomi Saeki ◽  
Toshiaki Watanabe
Keyword(s):  
Peptic Ulcer ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Omental Patch

Primary laparoscopic approach to repair perforated peptic ulcer. A retrospective cohort study

2020 ◽  
Vol 75 (6) ◽  
Author(s):  
Gianrocco Manco ◽  
Stefania Caramaschi ◽  
Giovanni Rolando ◽  
Marzio Malagoli ◽  
Giuliana Zanelli ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer

scholarly journals Laparoscopic repair for perforated peptic ulcer: our experience, a comparison with the open approach and a review of the literature.

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Samuele Vaccari ◽  
Vito D'Andrea ◽  
Augusto Lauro ◽  
Roberto D'Intino ◽  
Eliana Gulotta ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer ◽  
Suture Repair ◽  
Open Approach ◽  
Peptic Ulcers ◽  
Severe Condition ◽  
Extensive Experience ◽  
Optimal Outcomes ◽  
Immediate Surgery

Backgrounds: The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons. Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery. Methods: This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes. Results: The diagnosis was made clinically and confirmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died. Conclusions: Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach.

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