title: Laparoscopic repair of perforated duodenal ulcers: outcome and efficacy in 30 consecutive patients.
abstract: OBJECTIVE
  Laparoscopic management of perforated duodenal ulcers is safe and effective.
  
  
  METHODS
  Prospective nonrandomized controlled trial.
  
  
  METHODS
  Tertiary care academic center.
  
  
  METHODS
  Between October 1993 and October 1997, 30 patients underwent laparoscopic Graham patch repair of perforated duodenal ulcers and 16 had an open repair.
  
  
  METHODS
  Morbidity, operating time, analgesic requirements, length of hospital stay, and time to return to work.
  
  
  RESULTS
  There was no difference in morbidity between the 2 groups. Operating time was longer in the laparoscopy group (106 vs. 63 minutes; P = .001). Patients with shock on admission or symptoms for more than 24 hours had a higher conversion rate (P<.05). The laparoscopy group required fewer analgesics, had a shorter stay, and a quicker recovery.
  
  
  CONCLUSIONS
  Laparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.
authors.affiliation: Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA.
authors.forename: N
authors.initials: N
authors.lastname: Katkhouda
authors.forename: E
authors.initials: E
authors.lastname: Mavor
authors.forename: R J
authors.initials: RJ
authors.lastname: Mason
authors.forename: G M
authors.initials: GM
authors.lastname: Campos
authors.forename: A
authors.initials: A
authors.lastname: Soroushyari
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D009017:Morbidity; D009852:Omentum / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012769:Shock / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome