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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 1  |  Page : 62-68

Laparoscopic versus open repair of perforated duodenal peptic ulcer: a randomized controlled trial


General Surgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Adel S Zedan
General Surgery Department, Faculty of Medicine, Menoufia University, Yassin Abdel Ghaffar Street, Gamal Abdel Nasser Street, Shebin El-Kom, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.155945

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Objective The aim of this study was to compare between laparoscopic and laparotomy repair of perforated duodenal ulcer in terms of operative time, postoperative pain, postoperative complication, hospital stay, and resuming normal activity. Background Laparoscopic surgery has become a standard of care in many of the elective procedures; however, it is still gaining popularity in conditions associated with peritonitis, such as perforated duodenal ulcer. Materials and methods This is a prospective study that included 50 patients with perforated duodenal peptic ulcer admitted to the General Surgery Department in Menoufia University Hospitals from October 2012 to April 2014. The patients were divided by random serial number method into two groups: group A consisted of 25 patients for laparoscopic procedure, and group B consisted of 25 patients for open repair. Results In group A, 21 patients underwent successful laparoscopic surgery, and four patients were converted to laparotomy, and in group B, 24 patients were evaluable, and one patient died on the fourth postoperative day not related to surgical cause. Operating time was significantly longer in the laparoscopy group, 145 ± 8.4 versus 110 ± 13 min. Patients who underwent laparoscopic repair were associated with lower morbidity, with P-value less than 0.05. No significant difference was found regarding leak or intra-abdominal abscess. Hospital stay was significantly shorter in the laparoscopic group, 6.9 ± 2.2 versus 8.9 ± 3.3 days. Patients who underwent laparoscopic procedure resumed normal activity earlier than the patients in the laparotomy group, 14 ± 1.9 versus 20.5 ± 3.9 days, with P-value less than 0.001. Conclusion Laparoscopic correction of perforated peptic ulcer causes less postoperative pain, postoperative complications, and hospital stay.


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