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.

Predicting the Length of Hospital Stay After Surgery for Perforated Peptic Ulcer

2019 ◽  
pp. 569-579 ◽  
Author(s):  
José Machado ◽  
Ana Catarina Cardoso ◽  
Inês Gomes ◽  
Inês Silva ◽  
Vítor Lopes ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Perforated Peptic Ulcer

scholarly journals Laparoscopic and open repair of perforated peptic ulcer

2017 ◽  
Vol 4 (6) ◽  
pp. 2022
Author(s):  
Ahmed Abdel Monem Ibrahim ◽  
Backeet Turkeyev ◽  
Mohammad Mahmood Al Alkatary
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Perforated Peptic Ulcer ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Current Evidence ◽  
Open Approach

Background: The study included patients diagnosed as perforated peptic ulcer. Outcomes are assessed by mortality and morbidity rate, operation time and hospital length of stay.Methods: On the period from January 2013 to December 2014 a total of 71 patients were operated in both facilities: 37 patients in Dubai hospital and 34 in Mafraq Hospital. Open repair with omental patch done in 34 patients (47.9%) and laparoscopically in 37 patients (52.1%). No cases of laparoscopy converted to laparotomy.Results: The data demonstrates homogeneous results for the outcome variables of morbidity and complications, while operation time and hospital length of stay differ significantly. Statistical significance could not be reached for any of these variables, although odd ratios were consistently in favour of the laparoscopic repair. Similarly, the laparoscopic approach resulted in a lower rate of minor complications (10% vs. 23%). Total lengths of stay post open repair made of 4.2±1.2 days, after laparoscopic repair 3.6±0.9 days. At the same time there were observed longer operating times for laparoscopic repair of PPU which constituted 62±10.6 minutes whereas open repair took only 45±12.9 minutes. Peritoneal lavage has been a factor of prolonged duration of laparoscopic surgery.Conclusions: Laparoscopic repair of a perforated peptic ulcer is an amenable and feasible technique within the hands of experienced laparoscopic surgeon. Current evidence does not clearly demonstrate the advantages of laparoscopic versus open repair. Growing interest in the laparoscopic approach may encourage the design of additional randomized trials to analyze its efficacy compared with the open approach.

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.

scholarly journals Predictive Model for Length of Hospital Stay of Patients Surviving Surgery for Perforated Peptic Ulcer

2009 ◽  
Vol 108 (8) ◽  
pp. 644-652 ◽  
Author(s):  
Chin-Hsien Li ◽  
Ming-Jong Bair ◽  
Wen-Hsiung Chang ◽  
Shou-Chuan Shih ◽  
Shee-Chan Lin ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hospital Stay ◽  
Predictive Model ◽  
Length Of Hospital Stay ◽  
Perforated Peptic Ulcer

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 versus open distal pancreatectomy: a single centre propensity score matching analysis

2021 ◽  
Author(s):  
Riccardo Casadei ◽  
Carlo Ingaldi ◽  
Claudio Ricci ◽  
Laura Alberici ◽  
Emilio De Raffele ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Pancreatic Neoplasms ◽  
Postoperative Morbidity ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Single Centre ◽  
Oncological Outcomes ◽  
Open Distal Pancreatectomy

AbstractThe laparoscopic approach is considered as standard practice in patients with body-tail pancreatic neoplasms. However, only a few randomized controlled trials (RCTs) and propensity score matching (PSM) studies have been performed. Thus, additional studies are needed to obtain more robust evidence. This is a single-centre propensity score-matched study including patients who underwent laparoscopic (LDP) and open distal pancreatectomy (ODP) with splenectomy for pancreatic neoplasms. Demographic, intra, postoperative and oncological data were collected. The primary endpoint was the length of hospital stay. The secondary endpoints included the assessment of the operative findings, postoperative outcomes, oncological outcomes (only in the subset of patients with pancreatic ductal adenocarcinoma-PDAC) and total costs. In total, 205 patients were analysed: 105 (51.2%) undergoing an open approach and 100 (48.8%) a laparoscopic approach. After PSM, two well-balanced groups of 75 patients were analysed and showed a shorter length of hospital stay (P = 0.001), a lower blood loss (P = 0.032), a reduced rate of postoperative morbidity (P < 0.001) and decreased total costs (P = 0.050) after LDP with respect to ODP. Regarding the subset of patients with PDAC, 22 patients were analysed: they showed a significant shorter length of hospital stay (P = 0.050) and a reduction in postoperative morbidity (P < 0.001) after LDP with respect to ODP. Oncological outcomes were similar. LDP showed lower hospital stay and postoperative morbidity rate than ODP both in the entire population and in patients affected by PDAC. Total costs were reduced only in the entire population. Oncological outcomes were comparable in PDAC patients.

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

scholarly journals Risk Factors that Affect Morbidity and Mortality in Patients with Perforated Peptic Ulcer Diseases in a Teaching Hospital

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Nebyou Seyoum ◽  
Daba Ethicha ◽  
Zelalem Assefa ◽  
Berhanu Nega
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Addis Ababa ◽  
Previous History ◽  
Perforated Peptic Ulcer ◽  
Cross Sectional Study ◽  
Morbidity And Mortality ◽  
Delayed Presentation ◽  
Cross Sectional ◽  
Female Ratio

Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting.Methods: A two years (January 1, 2016 - December 30, 2018) retrospective cross- sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa,Ethiopia.Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was <10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(2-30)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP <90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate.Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential.

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