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 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.

scholarly journals Platelet to Lymphocyte Ratio Associated with Prolonged Hospital Length of Stay Postpeptic Ulcer Perforation Repair: An Observational Descriptive Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Omer Al-Yahri ◽  
Tamer Saafan ◽  
Husham Abdelrahman ◽  
Ammar Aleter ◽  
Ali Toffaha ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Length Of Stay ◽  
Lymphocyte Count ◽  
Perforated Peptic Ulcer ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Platelet To Lymphocyte Ratio ◽  
Cutoff Value ◽  
Lymphocyte Ratio ◽  
Prolonged Hospitalization

Background. The predictive role of platelet to lymphocyte ratio (P/LR) in patients with perforated peptic ulcer (PPU) is not well-studied. We aimed to investigate the association between the P/LR ratio and the hospital length of stay (HLOS) for surgically treated PPU. Method. This is a retrospective observational study for surgically treated adult cases of PPU at Hamad Medical Corporation during the period from January 2012 to August 2017. Patients were categorized into two groups based on their HLOS (<I week vs. >I week). The receiver operating characteristic (ROC) curve was plotted to determine the cutoff value for lymphocyte count, neutrophil to lymphocyte ratio, and P/LR ratio for predicting the prolonged hospitalization. Results. One hundred and fifty-two patients were included in the study. The majority were young males. The mean age was 38.3 ± 12.7 years. Perforated duodenal ulcer (139 patients) exceeded perforated gastric ulcer (13 patients). The HLOS > 1 week was observed in 14.5% of cases. Older age ( p = 0.01 ), higher preoperative WBC ( p = 0.03 ), lower lymphocyte count ( p = 0.01 ), and higher P/LR ratio ( p = 0.005 ) were evident in the HLOS > 1 week group. The optimal cutoff value of P/LR was 311.2 with AUC 0.702 and negative predictive value of 93% for the prediction of prolonged hospitalization. Two patients died with a mean P/LR ratio of 640.8 ± 135.5 vs. 336.6 ± 258.9 in the survivors. Conclusion. High preoperative P/LR value predicts prolonged HLOS in patients with repaired perforated peptic ulcer. Further larger multicenter studies are needed to support the study findings.

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 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

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 Laparoscopy in Liver Transplantation: The Future Has Arrived

HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Quirino Lai ◽  
Rafael S. Pinheiro ◽  
Giovanni B. Levi Sandri ◽  
Gabriele Spoletini ◽  
Fabio Melandro ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Scientific Progress ◽  
Laparoscopic Approach ◽  
Standard Of Care ◽  
Radical Change ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Therapeutic Laparoscopy ◽  
Stage Disease ◽  
End Stage

In the last two decades, laparoscopy has revolutionized the field of surgery. Many procedures previously performed with an open access are now routinely carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and hemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections. Liver transplantation (LT) brought a radical change in life expectancy of patients with hepatic end-stage disease. Today, LT represents the standard of care for more than fifty hepatic pathologies, with excellent results in terms of survival. Surely, with laparoscopy and LT being one of the most continuously evolving challenges in medicine, their recent combination has represented an astonishing scientific progress. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients.

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 Liver Surgery for Hepatocellular Carcinoma: Laparoscopic versus Open Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
C. G. Ker ◽  
J. S. Chen ◽  
K. K. Kuo ◽  
S. C. Chuang ◽  
S. J. Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Average Length ◽  
Survival Rates ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Open Approach ◽  
Full Diet ◽  
Or Groups ◽  
Significant Difference

In this study, we try to compare the benefit of laparoscopic versus open operative procedures.Patients and Methods. One hundred and sixteen patients underwent laparoscopic liver resection (LR) and another 208 patients went for open liver resection (OR) for hepatocellular carcinoma (HCC). Patients' selection for open or laparoscopic approach was not randomized.Results. The CLIP score for LR and OR was 0.59 ± 0.75 and 0.86 ± 1.04, respectively, (). The operation time was 156.3 ± 308.2 and 190.9 ± 79.2 min for LR and OR groups, respectively. The necessity for blood transfusion was found in 8 patients (6.9%) and 106 patients (50.9%) for LR and OR groups. Patients resumed full diet on the 2nd and 3rd postoperative day, and the average length of hospital stay was 6 days and 12 days for LR and OR groups. The complication rate and mortality rate were 0% and 6.0%, 2.9% and 30.2% for LR and OR groups, respectively. The 1-yr, 3-yr, and 5-yr survival rate was 87.0%, 70.4%, 62.2% and 83.2%, 76.0%, 71.8% for LR and OR group, respectively, of non-significant difference. From these results, HCC patients accepted laparoscopic or open approach were of no significant differences between their survival rates.

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