Comparison of Laparoscopic and Open Repair for Perforated Gastroduodenal Ulcer in Elderly Patients

Objective To investigate the value of laparoscopic repair and suture in the treatment of perforated gastroduodenal ulcer in elderly patients. Methods Sixty-two patients were assigned to receive either laparoscopic repair( laparoscopic group,n = 32) or open repair( open group,n = 30) for perforated gastroduodenal ulcer. Postoperative complications,postoperative out-of-bed activity time,anal exhaust time,hospital stay and analgesic use were observed in both groups. Results Among the 32 patients in laparoscopic group,28 underwent successful operation and 4 were converted to open repair due to the difficulty of suturing. In addition,2 of the 28 patients had postoperative pulmonary infection. Among the 30patients in open group,residual abscess was found in 1,incision infection in 2,adhesive intestinal obstruction in 2,and pulmonary infection in 4. The incidence of complications in open group( 30. 0%,9 /30)was significantly higher than that in laparoscopic group( 7. 1%,2 /28)( P 0. 05). Furthermore,laparoscopic repair significantly decreased out-of-bed activity time,anal exhaust time,hospital stay and analgesic usage compared with open repair( P 0. 01). Conclusion Compared with traditional open repair,laparoscopic repair for perforated gastroduodenal ulcer reduces trauma,pain and postoperative complications and promotes postoperative recovery in elderly patients.