Minilaparotomy for Perforated Duodenal Ulcer

2011 ◽  
Vol 96 (3) ◽  
pp. 194-200 ◽  
Author(s):  
Hideyuki Ishida ◽  
Toru Ishiguro ◽  
Kensuke Kumamoto ◽  
Tomonori Ohsawa ◽  
Jun Sobajima ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Significant Risk ◽  
Laparoscopic Approach ◽  
Significant Risk Factor ◽  
Skin Incision ◽  
Open Approach ◽  
Perforated Duodenal Ulcer ◽  
Invasive Approach ◽  
Minilaparotomy Approach ◽  
Conventional Open Approach

Abstract The usefulness of the minilaparotomy approach for perforated duodenal ulcer repair was retrospectively evaluated in 37 patients (26 men; mean age, 56.5 years). Simple closure with an omental patch by minilaparotomy (skin incision, ≤7 cm) was successful in 86.5% of the cases, with an operative mortality of 2.7%. Compared with the results in historic control patients who underwent conventional open surgery (n  =  27), a shorter operative time (P < 0.01), lower frequency of analgesic use (P  =  0.03), earlier passage of flatus (P < 0.01), and shorter hospital stay (P  =  0.04) were obtained in the patients undergoing minilapartomoy. The postoperative morbidity was identical between the two groups (16.2% versus 33.3%, P  =  0.40). On multivariate analysis, a large amount of intra-abdominal fluid was the only significant risk factor for extension of the minilaparotomy wound (P  =  0.012). The minilaparotomy approach appears to be a feasible, safe, and less invasive approach compared with the conventional open approach and could be a useful alternative to the laparoscopic approach in selected patients with perforated duodenal ulcer.

scholarly journals Laparoscopic Resection for Rectal Cancer: What Is the Evidence?

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Dedrick Kok-Hong Chan ◽  
Choon-Seng Chong ◽  
Bettina Lieske ◽  
Ker-Kan Tan
Keyword(s):  
Rectal Cancer ◽  
Randomised Controlled Trials ◽  
Laparoscopic Resection ◽  
Laparoscopic Approach ◽  
Oncologic Outcomes ◽  
Controlled Trials ◽  
Open Approach ◽  
Invasive Approach ◽  
Randomised Controlled

Laparoscopic colectomy for colon cancer is a well-established procedure supported by several well-conducted large-scale randomised controlled trials. Patients could now be conferred the benefits of the minimally invasive approach while retaining comparable oncologic outcomes to the open approach. However, the benefits of laparoscopic proctectomy for rectal cancer remained controversial. While the laparoscopic approach is more technically demanding, results from randomised controlled trials regarding long term oncologic outcomes are only beginning to be reported. The impacts of bladder and sexual functions following proctectomy are considerable and are important contributing factors to the patients’ quality of life in the long-term. These issues present a delicate dilemma to the surgeon in his choice of operative approach in tackling rectal cancer. This is compounded further by the rapid proliferation of various laparoscopic techniques including the hand assisted, robotic assisted, and single port laparoscopy. This review article aims to draw on the significant studies which have been conducted to highlight the short- and long-term outcomes and evidence for laparoscopic resection for rectal cancer.

Comparison of the Mini-open versus Laparoscopic Approach for Anterior Lumbar Interbody Fusion: A Retrospective Review

Neurosurgery ◽  
2002 ◽  
Vol 51 (1) ◽  
pp. 97-105 ◽  
Author(s):  
Michael G. Kaiser ◽  
Regis W. Haid ◽  
Brian R. Subach ◽  
Jay S. Miller ◽  
C. Dan Smith ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Interbody Fusion ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Anterior Lumbar Interbody Fusion ◽  
Attractive Alternative ◽  
Open Approach ◽  
Lumbar Interbody Fusion ◽  
Invasive Approach ◽  
Mini Open

Abstract OBJECTIVE The anterior lumbar interbody fusion (ALIF) procedure has become an accepted fusion technique for treating patients with degenerative disorders of the lumbar spine. Many consider laparoscopic ALIF to be the least invasive approach. A modification of the open laparotomy—the “mini-open” approach—is an attractive alternative. In this retrospective review, a comparison of these two ALIF approaches is presented. METHODS We conducted a retrospective review of 98 patients who underwent ALIF procedures between 1996 and 2001 in which either a mini-open or a laparoscopic approach was used. Patient demographics, intraoperative parameters, length of hospitalization, and technique-related complications associated with the use of these two approaches were compared. The subset of patients who underwent L5–S1 ALIF procedures was analyzed separately. Statistical analysis was conducted with χ2 and Student's paired t tests. RESULTS Between 1996 and 2001, a total of 98 patients underwent ALIF. A laparoscopic approach was used in 47 of these patients, and the mini-open technique was used in the other 51 patients. Operative preparation and procedure time were longer with the use of a laparoscopic approach, and significantly greater during L5–S1 ALIF procedures (P < 0.05). A marginal but significant increase in length of stay was observed after mini-open ALIF procedures (P < 0.05). The immediate postoperative complication rate was greater after mini-open ALIF procedures, 17.6 versus 4.3% (P < 0.05); however, the rate of retrograde ejaculation was higher in the laparoscopic group, 45 versus 6% (P < 0.05). CONCLUSION Both the laparoscopic and mini-open techniques are effective approaches to use when performing ALIF procedures. On the basis of the data obtained in this retrospective review, the laparoscopic approach does not seem to have a definitive advantage over the mini-open exposure, particularly in an L5–S1 ALIF procedure. In our opinion, the mini-open approach possesses a number of theoretical advantages; however, the individual surgeon's preference ultimately is likely to be the dictating factor.

scholarly journals Falciform ligament use in perforated duodenal ulcer repair: a case report and literature review

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Amr Elgazar ◽  
Ahmed K Awad ◽  
Sheref A Elseidy
Keyword(s):  
Duodenal Ulcer ◽  
Abdominal Cavity ◽  
Clinical Status ◽  
Laparoscopic Approach ◽  
Greater Omentum ◽  
Falciform Ligament ◽  
Perforated Duodenal Ulcer ◽  
Duodenal Ulcers ◽  
Omental Patch ◽  
Surgical Conditions

Abstract Acute perforated duodenal ulcers are considered one of the most encountered emergency surgical conditions leading to mortality. Different approaches have been proposed for management based on the clinical status of the patient. The use of omental patch closure is widely accepted either via an open or laparoscopic approach. However, not all patients are candidates owing to the availability and viability of the greater omentum. In these patients, the falciform ligament can be used as an alternative and efficient method for repair. In this case, we present a male patient with a perforated ulcer in the first part of the duodenum which was managed by falciform ligament patch instead of the usual omental patch. In cases of a deficient or unhealthy greater omentum, or if it cannot be brought in the upper part of the abdominal cavity due to severe adhesions, the falciform ligament can be used efficiently in the closure of perforated duodenal ulcer.

scholarly journals Laparoscopic cloasure of Duodenal ulcer perforation

2016 ◽  
Vol 18 (3) ◽  
pp. 16
Author(s):  
Anang Pangeni ◽  
Vikal Chandra Shakya
Keyword(s):  
Duodenal Ulcer ◽  
Young Patients ◽  
Laparoscopic Approach ◽  
Duodenal Perforation ◽  
Invasive Approach ◽  
Ulcer Perforation ◽  
Perforation Peritonitis ◽  
The Mean ◽  
A Prospective Study ◽  
Duodenal Ulcer Perforation

Introduction and Objective: Duodenal ulcer perforation creates a peritonitis which is sometimes hard to manage, especially with minimally invasive approach. This study is about laparoscopic approach to peritonitis due to duodenal ulcer perforation.Materials and Methods: It was a prospective study in patients presenting with duodenal perforation peritonitis to emergency of Civil Service Hospital from January 2013 to November 2015.Result: There were 6 patients (4 males and 2 females). The mean duration of presentation was 16+2.32 hrs. The mean operative time was 55+17.34 minutes. One patient developed right lower zone pneumonia which resolved on conservative management. There was no conversion.Conclusion: Laparoscopic management of duodenal perforation is a feasible procedure in select young patients who present early and without any without comorbities

scholarly journals Laparoscopic management of cholecystoduodenal fistula: a case report

2018 ◽  
Vol 5 (11) ◽  
pp. 3744
Author(s):  
Tharun Ganapathy C. ◽  
Jeyakumar S. ◽  
Manimaran P. ◽  
Sidhu Sekhar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Laparoscopic Approach ◽  
Open Approach ◽  
Cholecystoduodenal Fistula ◽  
Cholecystoenteric Fistula ◽  
Bladder Pathology ◽  
Almost All ◽  
Conventional Open Approach ◽  
Laparoscopic Techniques

Laparoscopic cholecystectomy has been the most widely accepted modality of treatment for patients with gall bladder disease. With time and increasing experience laparoscopic cholecystectomy is now being successfully attempted to treat almost all benign gall bladder pathology and their complications. One such uncommon infrequent complication of cholecystolithiasis is the cholecystoenteric fistula. Management of cholecystoduodenal fistula was traditionally performed by open method. With increasing newer laparoscopic techniques and advancement in the field, cholecystoduodenal fistula, an uncommon clinical entity is now being successfully treated via laparoscopic approach. It is feasible and safer than the conventional open approach in experienced hands, thus decreasing the overall morbidity and mortality attributed to the condition. We report a case of cholecystoduodenal fistula treated successfully by laparoscopic approach using an Endo GIA stapler.

Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Cun-Xian Jia ◽  
Lin-Lin Wang ◽  
Ai-Qiang Xu ◽  
Ai-Ying Dai ◽  
Ping Qin
Keyword(s):  
Risk Factor ◽  
Family Income ◽  
Rural China ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Health Condition ◽  
Physical Illness ◽  
Rural Residents ◽  
Increased Risk ◽  
Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

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