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. 1996 Aug;224(2):131–138. doi: 10.1097/00000658-199608000-00004

A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique.

W Y Lau 1, K L Leung 1, K H Kwong 1, I C Davey 1, C Robertson 1, J J Dawson 1, S C Chung 1, A K Li 1
PMCID: PMC1235333  PMID: 8757375

Abstract

OBJECTIVE: This study compares laparoscopic versus open repair and suture versus sutureless repair of perforated duodenal and juxtapyloric ulcers. BACKGROUND DATA: The place of laparoscopic repair of perforated peptic ulcer followed by peritoneal toilet of the peritoneal cavity has been established. Whether repair of the perforated peptic ulcer by the laparoscopic approach is better than conventional open repair and whether sutured repair is better than sutureless repair are both undetermined. METHODS: One hundred three patients were randomly allocated to laparoscopic suture repair, laparoscopic sutureless repair, open suture repair, and open sutureless repair. RESULTS: Laparoscopic repair of perforated peptic ulcer (groups 1 and 2) took significantly longer than open repair (groups 3 and 4; 94.3 +/ 40.3 vs. 53.7 +/ 42.6 minutes: Student's test, p < 0.001), but the amount of analgesic required after laparoscopic repair was significantly less than in open surgery (median 1 dose vs. 3 doses) (Mann-Whitney U test, p = 0.03). There was no significant difference in the four groups of patients in terms of duration of nasogastric aspiration, duration of intravenous drip, total hospital stay, time to resume normal diet, visual analogue scale score for pain in the first 24 hours after surgery, morbidity, reoperation, and mortality rates. CONCLUSIONS: Laparoscopic repair of perforated peptic ulcer is a viable option. Sutureless repair is as safe as suture repair and it takes less time to perform.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baron J. H. Peptic ulcers can now be cured without operation. Ann R Coll Surg Engl. 1995 May;77(3):168–173. [PMC free article] [PubMed] [Google Scholar]
  2. Benoit J., Champault G. G., Lebhar E., Sezeur A. Sutureless laparoscopic treatment of perforated duodenal ulcer. Br J Surg. 1993 Sep;80(9):1212–1212. doi: 10.1002/bjs.1800800952. [DOI] [PubMed] [Google Scholar]
  3. Boey J., Wong J., Ong G. B. A prospective study of operative risk factors in perforated duodenal ulcers. Ann Surg. 1982 Mar;195(3):265–269. doi: 10.1097/00000658-198203000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Boey J., Wong J. Perforated duodenal ulcers. World J Surg. 1987 Jun;11(3):319–324. doi: 10.1007/BF01658109. [DOI] [PubMed] [Google Scholar]
  5. Bohnen J. M., Solomkin J. S., Dellinger E. P., Bjornson H. S., Page C. P. Guidelines for clinical care: anti-infective agents for intra-abdominal infection. A Surgical Infection Society policy statement. Arch Surg. 1992 Jan;127(1):83–89. doi: 10.1001/archsurg.1992.01420010097015. [DOI] [PubMed] [Google Scholar]
  6. Crofts T. J., Park K. G., Steele R. J., Chung S. S., Li A. K. A randomized trial of nonoperative treatment for perforated peptic ulcer. N Engl J Med. 1989 Apr 13;320(15):970–973. doi: 10.1056/NEJM198904133201504. [DOI] [PubMed] [Google Scholar]
  7. Jordan P. H., Jr, Morrow C. Perforated peptic ulcer. Surg Clin North Am. 1988 Apr;68(2):315–329. doi: 10.1016/s0039-6109(16)44480-4. [DOI] [PubMed] [Google Scholar]
  8. Kum C. K., Isaac J. R., Tekant Y., Ngoi S. S., Goh P. M. Laparoscopic repair of perforated peptic ulcer. Br J Surg. 1993 Apr;80(4):535–535. doi: 10.1002/bjs.1800800441. [DOI] [PubMed] [Google Scholar]
  9. Lau W. Y., Leung K. L., Zhu X. L., Lam Y. H., Chung S. C., Li A. K. Laparoscopic repair of perforated peptic ulcer. Br J Surg. 1995 Jun;82(6):814–816. doi: 10.1002/bjs.1800820630. [DOI] [PubMed] [Google Scholar]
  10. Mouret P., François Y., Vignal J., Barth X., Lombard-Platet R. Laparoscopic treatment of perforated peptic ulcer. Br J Surg. 1990 Sep;77(9):1006–1006. doi: 10.1002/bjs.1800770916. [DOI] [PubMed] [Google Scholar]
  11. Nathanson L. K., Easter D. W., Cuschieri A. Laparoscopic repair/peritoneal toilet of perforated duodenal ulcer. Surg Endosc. 1990;4(4):232–233. doi: 10.1007/BF00316801. [DOI] [PubMed] [Google Scholar]
  12. Périssat J., Collet D., Edye M. Therapeutic laparoscopy. Endoscopy. 1992 Jan-Feb;24(1-2):138–143. doi: 10.1055/s-2007-1010452. [DOI] [PubMed] [Google Scholar]
  13. Rauws E. A., Tytgat G. N. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990 May 26;335(8700):1233–1235. doi: 10.1016/0140-6736(90)91301-p. [DOI] [PubMed] [Google Scholar]
  14. Sunderland G. T., Chisholm E. M., Lau W. Y., Chung S. C., Li A. K. Laparoscopic repair of perforated peptic ulcer. Br J Surg. 1992 Aug;79(8):785–785. doi: 10.1002/bjs.1800790825. [DOI] [PubMed] [Google Scholar]
  15. Tate J. J., Dawson J. W., Lau W. Y., Li A. K. Sutureless laparoscopic treatment of perforated duodenal ulcer. Br J Surg. 1993 Feb;80(2):235–235. doi: 10.1002/bjs.1800800239. [DOI] [PubMed] [Google Scholar]

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