scholarly journals Generalized peritonitis requiring re-operation after leakage of omental patch repair of perforated peptic ulcer

2011 ◽  
Vol 17 (2) ◽  
pp. 124 ◽  
Author(s):  
Hemmat Maghsoudi ◽  
Alireza Ghaffari
Keyword(s):  
Peptic Ulcer ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Omental Patch ◽  
Generalized Peritonitis

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 < 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 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

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.

FEASIBILITY OF ERAS (ENHANCED RECOVERY AFTER SURGERY) PROTOCOL IN PATIENTS UNDERGOING EMERGENCY REPAIR FOR PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 41-43
Author(s):  
Chayan Rui ◽  
Chandan Roy Choudhury ◽  
Puspak Ghosh
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Tertiary Care ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Care Hospital ◽  
Ulcer Disease ◽  
Emergency Repair

Introduction: The surgical treatment of perforated peptic ulcer disease has evolved in parallel to advances in medical treatment of Peptic Ulcer Disease. Objective: To investigate the feasibility of ERAS (Enhanced Recovery after Surgery) Pathways in patients undergoing emergency repair for Perforated peptic ulcer disease. Materials and methods: Institutional based prospective analytical study. Indoor patients in Dept. of General Surgery in Medical College and Hospital Kolkata. January 2019 to June 2020. Study was conducted for 18 months.14 months was provided for data collection. Next 2 months for statistical analysis and another 2 months for thesis writing and submission. Conclusion: ERAS pathway (with some modications) seems to be safe and feasible in a highly selected subset of patients undergoing emergency Omental grahams patch repair of Perforated Peptic Ulcer Disease

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 Surgical outcome of management of perforated peptic ulcer: retrospective analysis of 148 cases

2019 ◽  
Vol 6 (10) ◽  
pp. 3643
Author(s):  
Salamat Khan ◽  
O. P. Gupta
Keyword(s):  
Peptic Ulcer ◽  
Fluid Resuscitation ◽  
Perforated Peptic Ulcer ◽  
Exploratory Laparotomy ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Omental Patch ◽  
Hemodynamic Status ◽  
Peritoneal Drainage ◽  
H Pylori

Background: Perforated peptic ulcer (PPU) is a common life threatening surgical emergency. Discovery of H. pylori (1985) changed the concept of the management of peptic ulcer. Now-a-days reduction in gastric acid production with proton pump inhibitors along with eradication of H. pylori is recommended.Methods: Clinically suspected cases of PPU were confirmed by radiological and laboratory investigation. These patients were subjected to exploratory laparotomy with Graham’s omental patch repair after adequate fluid resuscitation with optimal hemodynamic status with or without peritoneal drainage, except in too sick patients. Postoperatively; these patients kept in SICU and closely monitored. Data were collected, tabulated and analyzed.Results: Out 150 cases enrolled, 2 cases died before exploratory laparotomy and closure of operation. So only 148 took part in the study. Male patients were predominant than female in a ratio of 148:2. Age ranges from 20 to >60 years. Majority of the patients belongs to the age group 30-40 years of age. The morbidity and mortality rates were 20% and 2.7% respectively.Conclusions: Adequate fluid resuscitation with optimal hemodynamic status and optimal kidney function is the key to decrease morbidity and mortality rates. Simple closure with omental patch followed by H. pylori eradication is effective with excellent outcome in most of survivor despite of late presentation. Old concept of prophylactic peritoneal drainage and “no sunset no sun rise” concept of operation should be discouraged as it is not beneficial. Definitive surgery for ulcer recurrence is no more done except in special situation.

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