Title: Laparoscopic Primary Repair using omentum for Duodenal Ulcer Perforation: A Single Institution Experience of 12 Cases in one year
Authors: Kunal Chowdhary, Muzzafar Zaman, Aliya Shah, Kapil Sindhu
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.145
Abstract
Introduction: Duodenal ulcers are defined as mucosal breaks of 3 mm or greater and account for about two thirds of all peptic ulcers.Perforation of ulcer is one of the known complications seen in in such a patient presenting in emergency ward of a hospital .Inspite of great advances in Laparoscopic surgery nowadays ,most of the general surgeons are not well versed with laparoscopic repair of duodenal ulcer perforation.
Aim: To check the efficacy of laparoscopic repair of duodenal ulcer perforation in terms of various patient parameters.
Materials and Methods: This is a prospective randomised hospital based study .The procedure was performed in 12 patients from March 2017 to April 2018 presenting to emergency department with features of peritonitis as a result of peptic ulcer perforation. The procedure for laparoscopic primary repair with omental flap consisted of peritoneal lavage, primary suture of perforation , and omentopexy.
Results: The median operation time was 56.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 5 (3~14 days). After surgery, the median hospital stay was 7.0 days (5~20 days). Postoperative complications occurred in one patient, which included mild acute pancreatitis. This complication was resolved by conservative management. During the operation, no conversion to open surgery or intra-operative events occurred.
Conclusion: Although our study was carried out on a small number of patients at a single institution, from the study we can conclude that laparoscopic repair of duodenal ulcer perforation can be an effective surgical method in the treatment of duodenal ulcer perforation if there is no absolute contraindication to laparoscopic surgery.
Keywords: duodenal ulcer, laparoscopy, primary repair, peritonitis
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