Laparoscopic Repair of Peptic Ulcer Perforation - Single Centre Experience

Abstract

Introduction: Laparotomy with peritoneal lavage and perforation repair is the standard management of perforated peptic ulcer. But the open surgery is associated with increased morbidity and delay in returning to routine activities. Laparoscopic procedures are associated with less pain post-operatively with early return to daily activities. Aim: To assess the feasibility of laparoscopy in the management of peptic ulcer perforation at our centre. Materials and Methods: It was an observational study, conducted from June 2009 to November 2011. Patients with peptic ulcer perforation aged 18-50 years, presenting within 72 hours of initiation of symptoms were included. Feasibility of laparoscopic repair was evaluated in terms of intra-op difficulties during repair, operative duration, postop recovery and complications. Descriptive statistic was used. Results: All 42 patients were male with mean age of 29.3 years. Seventy six percent patients presented within 48 hours. Mean duration for repair was 69.34 minutes. Ryle’s tube was kept for mean duration of 2.14 days. Mean duration for drain removal was 4.24 days and for hospital stay, it was 5.52 days. Conclusion: It is feasible to use laparoscopy for repair of perforation in earlier presenting patients.

Keywords

• lloyd-davis position
• port placement
• stomach retraction