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 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.

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 Patients With Perforated Peptic Ulcers: Risk Factors for Morbidity and Mortality

2019 ◽  
Vol 103 (11-12) ◽  
pp. 578-584
Author(s):  
Fatih Ciftci ◽  
Fazilet Erözgen
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Postoperative Period ◽  
Perforated Peptic Ulcer ◽  
Apache Ii ◽  
Morbidity And Mortality ◽  
Apache Ii Score ◽  
Peptic Ulcers ◽  
Presentation Time ◽  
Independent Risk Factors

Perforated peptic ulcers continue to be an important problem in surgical practice. In this study, risk factors for peptic ulcer perforation-associated mortality and morbidity were evaluated. This is a retrospective study of patients surgically treated for perforated peptic ulcer over a decade (March 1999–December 2014). Patient age, sex, complaints at presentation, time lapse between onset of complaints and presentation to the hospital, physical findings, comorbidities, laboratory and imaging findings, length of hospitalization, morbidity, and mortality were recorded. The Mannheim peritonitis index (MPI) and Acute Physiology and Chronic Health Evaluation (APACHE) II score were calculated and recorded for each patient on admission to the hospital. Of the 149 patients, mean age was 50.6 ± 19 years (range: 17–86). Of these, 129 (86.5%) were males and 20 (13.4%) females. At least 1 comorbidity was found in 42 (28.1%) of the patients. Complications developed in 36 (24.1%) of the patients during the postoperative period. The most frequent complication was wound site infection. There was mortality in 26 (17.4%) patients and the most frequent cause of mortality was sepsis. Variables that were found to have statistically significant effects on morbidity included age older than 60 years, presence of comorbidities, and MPI (P = 0.029, 0.013, and 0.013, respectively). In a multivariate analysis, age older than 60 years, presence of comorbidities, and MPI were independent risk factors that affected morbidity. In the multivariate logistic regression analysis, age older than 60 years [P = 0.006, odds ratio (OR) = 5.99, confidence interval (CI) = 0.95] and comorbidities (OR = 2.73, CI = 0.95) were independent risk factors that affected morbidity. MPI and APACHE II scoring were both predictive of mortality. Age older than 60, presentation time, and MPI were independent risk factors for mortality. Undelayed diagnosis and appropriate treatment are of the utmost importance when presenting with a perforated peptic ulcer. We believe close observation of high-risk patients during the postoperative period may decrease morbidity and mortality rates.

scholarly journals Early Detection and Intervention for Acute perforated Peptic Ulcer after Elective Spine Surgeries: A Review of 13 Cases from 24,026 Patients

2021 ◽  
Author(s):  
Fu-Cheng Kao ◽  
Tung-Yi Lin ◽  
Ping-Yeh Chiu ◽  
Tsung-Ting Tsai ◽  
Tsai-Sheng Fu ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Spine Surgery ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Perforated Peptic Ulcer ◽  
Sudden Onset ◽  
Control Group ◽  
Amylase Level ◽  
Study Group ◽  
Peptic Ulcers

Abstract Background:To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgeryMethods:Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed.Results:Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressive. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. Conclusion:Spine surgeons should be highly suspicious of a perforated peptic ulcer if a patient with abnormal high serum amylase level, a history of peptic ulcer and nonsteroidal anti-inflammatory druguse experiences, progressive pain in the epigastrium accompanied by abdominal rigidity and absent bowel sounds. Early diagnosis and emergency surgical intervention promote better outcomes.

scholarly journals PERFORATED PEPTIC ULCERS: 3 YEAR EXPERIENCE IN KLAIPEDA UNIVERSITY HOSPITAL

2019 ◽  
Vol 29 (2) ◽  
pp. 39-43
Author(s):  
Šarūnas Dailidėnas ◽  
Martynas Garčauskis ◽  
Gintarė Srėbaliūtė ◽  
Jonas Jurgaitis ◽  
Paulius Žeromskas ◽  
...  
Keyword(s):  
Data Analysis ◽  
Perforated Peptic Ulcer ◽  
University Hospital ◽  
Type I ◽  
Open Approach ◽  
Peptic Ulcers ◽  
Type Ii ◽  
Average Hospital ◽  
Mannheim Peritonitis Index ◽  
The Mean

Perforation is second most common complication of peptic ulcers with mortality rate ranging from 3 to 30 %. For best outcomes this condition must be diagnosed and managed as soon as possible. Objectives and methods. The aim of this study was to present our clinical experience in managing perforated peptic ulcers. Retrospective data analysis of patients treated for perforated peptic ulcers from year 2015 to 2017 was performed. Statistical data analysis was carried out using the SPSS 20.0 software. Results. 90 patients were treated for perforated peptic ulcers. The female and male ratio was 1:1.25 with the mean patient age of 61.60±19.42 years. There were no more data from 16 patients. The average hospital stay was 12.89±13.31 days. 11% of the patients had type I, 49% – type II, 24% – type III, 5%- type IV, 11% – type V ulcer according to modified Johnson classification. 91% underwent ulcerorrhaphy, 4% -Billroth type I surgery, 2% – Billroth type II surgery and 1% had atypic resection. 84% of surgeries were performed with laparotomic approach, 12% – laparos-copically, 4% had a conversion. The mean duration of the operation was 85.2±4.64 minutes. The average Mannheim Peritonitis Index between the patients was 17.135±7.36. 24% of patients with perforated peptic ulcer died. Statistically significant correlation was observed between the Mannheim Peritonitis Index and mortality (r=0.640; p<0.05), age and mortality (r=0.459; p<0.05) and between age and Mannheim Peritonitis Index (r=0.740; p<0.05). Conclusion. During the period from 2015 to 2017 90 patients were treated for PPU. Half of the patients had type II ulcer localization according to modified Johnson classification. Simple closure was performed for 91% of the patients, 84% of all surgeries were performed with an open approach. Statistically significant correlation was found between Mannheim Peritonitis Index and mortality, age and mortality and between age and Mannheim Peritonitis Index. No significant correlation was observed between the approach and the outcome. There could be a bigger role in laparascopic surgery treating PPU. It is important for clinicists to consider about PPI for treatment when prescribing NSAIDs, especially in elderly and hospitalized patients in order to avoid peptic ulcers and its complications.

scholarly journals P-BN10 Seasonal Variation of Presentation of Perforated Peptic Ulcer Disease: An Overview of Patient Demographics, Management and Outcomes in Northern Ireland

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Bakhat Yawar ◽  
Ahmed Marzouk ◽  
Heba Ali ◽  
Alsarah Diab ◽  
Hassan Abdulrahman ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Seasonal Variation ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcers ◽  
Northern Irish ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Patient Demographics ◽  
Acute Peritonitis

Abstract Background Perforated peptic ulcer disease is one of the most common causes of acute peritonitis. It carries significant mortality and morbidity. Several previous studies have reported a seasonal variation in presentation of patients with perforated ulcers. Here we present this study from a Northern Irish perspective on perforated peptic ulcers. Methods A retrospective cohort study was conducted on perforated peptic ulcer patients who presented to Altnagelvin Area Hospital emergency department between 2015 to 2020. Data on patient demographics, clinical presentation, investigations, management and outcomes were collected. Primary outcome was to investigate if seasonality was associated with incidence of perforated peptic ulcers. Follow-up data was also collected. Seasons were defined as per UK Met Office. Results Results:  A total of 50 patients presented with perforated PUD. Male:female ratio was approximately 3:2. Peaks were noted in spring and winter. April was the most common month for presentation followed by December. Smoking was the most common risk factor followed by alcohol abuse. 14 patients (28%) were either very frail or had contained perforations and were conservatively managed. 3 deaths were noted (6%). 13 patients (26%) required ICU admission at some stage in their management. Conclusions Slight seasonal variation was noted in presentation of perforated peptic ulcers in our study with more common incidence in winter and spring months. The month of April was noted to have the peak incidence of the disease in our study.

Perforated Peptic Ulcer: Laparoscopic Approach

2000 ◽  
Vol 166 (5) ◽  
pp. 405-408 ◽  
Author(s):  
Ivan Michelet, Ferdinando Agresta
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer

scholarly journals Early detection and intervention for acute perforated peptic ulcer after elective spine surgeries: a review of 13 cases from 24,026 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tung-Yi Lin ◽  
Yu-Chun Chuang ◽  
Fu-Cheng Kao ◽  
Chiu Ping-Yeh ◽  
Tsung-Ting Tsai ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Blood Loss ◽  
Spine Surgery ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Perforated Peptic Ulcer ◽  
Control Group ◽  
Amylase Level ◽  
Study Group ◽  
Peptic Ulcers

Abstract Background To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery. Methods Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed. Results Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. Conclusion Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.

scholarly journals RETROSPECTIVE STUDY OF PERFORATED PEPTIC ULCER: A TERTIARY HOSPITAL BASED STUDY

2020 ◽  
pp. 1-3
Author(s):  
Omprakash Raj ◽  
Sumit Dhruve
Keyword(s):  
Peptic Ulcer ◽  
Retrospective Study ◽  
Standard Procedure ◽  
Common Factor ◽  
Perforated Peptic Ulcer ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Peptic Ulcers ◽  
Case File ◽  
Ulcer Perforation

Background: Peptic Ulcer Perforation is an important and common emergency. One of the most dreaded and common complication of peptic ulcers is perforation. Perforations account for about 5% of peptic ulcers. Aim and Objectives: The aim of this study is clinical study of perforated peptic ulcer with objectives to assess the socio demographic distribution of peptic ulcer and to assess the clinical presentations and management of peptic ulcer perforation. Methodology: This was a retrospective study conducted in Chhattisgarh Institute of Medical Sciences Bilaspur in year 2018-2019. Total 158 patients were taken, who were diagnosed and operated for perforated peptic ulcer. Detail history and clinical findings were taken from case file. Result: a total 158 patients were studied, 76% were male, and 41-50 years age group was commonly affected. Alcohol consumption, old age, comorbid illness and pre admission delayed was most common factor. Abdominal pain i.e. 100% was most common presentation. Duodenal perforation was common i.e.38.60%. omentopaxy was preferable mode of repair perforation. Conclusion: Perforation of peptic ulcer is one of the common surgical emergencies and requires awareness and prompt management and operation. It mostly affects young and middle aged males in the thirties. Simple closure with omentopaxy is standard procedure.

scholarly journals Prakiurusios pepsinės opos Baltarusijoje: praeitis ir dabartis

2006 ◽  
Vol 4 (1) ◽  
pp. 0-0
Author(s):  
Vladimir M. Lobankov
Keyword(s):  
Peptic Ulcer ◽  
Regional Differences ◽  
Perforated Peptic Ulcer ◽  
Living Standards ◽  
Socioeconomic Factor ◽  
Peptic Ulcers ◽  
Population Changes ◽  
Ulcer Complications ◽  
Medical University

Perforated peptic ulcers in Belarus: past and present Vladimir M. LobankovDepartment of Hospital Surgery,Gomel State Medical University,Lange str. 5, 246000 Gomel, BelarusE-mail: [email protected] Objective The monitoring of perforated peptic ulcer incidence in Belarus is reviewed for the years 1960–2004. Methods The review of the annual incidence of perforated peptic ulcers during 1960–2004 is based on the official statistics of the Belorussian Ministry of Public Health. The index of perforated ulcer incidence per 100,000 population has been derived, with the account of population changes during these years. Results Mild variations of these statistics were observed before the 90s with an insignifcant tendency to grow from the second half of the 70s to the first half of the 80s. The Chernobyl accident in 1986 was not followed by any response. The incidence of perforated peptic ulcers almost doubled in the first half of the 90s, regional differences in the statistics appeared. These changes coincided with the collapse of the USSR and deterioration of the living standards. Hence, the socioeconomic factor has a dominating influence governing the risk of peptic ulcer complications, perforations in particular. Conclusion The author emphasizes the need to promote the role of public prophylaxis and definite preventive surgery for the patients with a severe ulcer evolution. Key words: perforated peptic ulcer, incidence

Sign in / Sign up

Export Citation Format

Share Document