A Comparative Study of Laparoscopic vs Open Surgery for the Management of Duodenal Ulcer Perforation

Approximately, 10 to 20% of patients with peptic ulcer suffer a perforation of stomach or duodenum in which chemical peritonitis develop initially from gastric and duodenal secretion but in a few hours bacterial contamination superimpose the disease. The disease could be life-threatening, early diagnosis and treatment is extremely important. The mortality will increase up if perforation exists more than 24 to 48 hours. Usually the only surgical procedure that is necessary is simple closure with omental patch. When repair of perforated ulcer can be achieved by suture closure, laparoscopic approach seems to be appropriate. This study aims at evaluating efficacy, safety and outcome of laparoscopic surgery for perforated duodenal ulcer. Patients admitted with perforated duodenal ulcer perforation, during the period of January 2010 to January 2011 at RL Jalappa Hospital and Research Center were evaluated. A total 61 cases were diagnosed as peritonitis secondary to duodenal perforation were involved in study. Thirty underwent laparoscopic closure and 31 underwent open surgeries which were nonrandomized. The results of study revealed lesser antibiotic open: lap (5:4.03 days; p = 0.001), analgesic requirement (7:4.87 days; p = 0.001) and lesser hospital stay (8:6.17 days; p = 0.001) and reduced postoperative complications open-three (9%): lap-one (3%) patients. The duration of surgery was more with laparoscopic surgery (open-56: lap-62.17 minutes; p = 0.003) since we are at initial stages at laparoscopic management for DU perforation, also depend on skill of surgeon but it had no effect on the overall outcome. Three (9.6%) patients in lap group were needed conversion to open surgery.