Laparoscopic Repair with Omental Patch for Perforated Duodenal Ulcer

Purpose: Laparoscopic surgery is now being applied to most abdominal surgeries. We evaluated the surgical outcomes of laparoscopic primary repair with an omental patch for treating perforated duodenal ulcer as compared to that of open surgery. Methods: A total of 124 consecutive patients who underwent repair of perforated peptic ulcer from January 2000 to February 2009 were included in the study. The surgical outcomes that were evaluated were the operation time, the use of intravenous/intramuscular analgesics, the complication rate, the hospital stay and the postoperative endoscopic findings. Results: 124 patients underwent surgical repair for perforated peptic ulcer disease (81 open repairs and 43 laparoscopic repairs). The mean age was 43.7±16.6 in the laparoscopic group and 45.7±18.3 in the open group, respectively (p=0.55). Laparoscopic repair had a similar operation time as open repair (110.4±37.5 minutes vs 101.2±30.8 minutes p=0.149, respectively). There were statistical differences for the hospital stay (7.8±3.0 days laparoscopy vs 9.9±4.0 days open; p=0.004) and the need for analgesics (range; 0∼17 open vs 0∼16 laparoscopic;p=0.026). But the complication rate was not significant different in both group (2.3% open vs 12.3% laparoscopic; p=0.062). Conclusion: Laparoscopic repair is a feasible and safe surgical option for patients with perforated peptic ulcer and it is an excellent alternative to open procedure when performed by experienced hands.