Comparison between open and laparoscopic technique in the management of perforated gastroduodenal ulcers.
OBJECTIVE
The aim of this study was to evaluate our results of laparoscopic treatment of perforated gastroduodenal ulcers during a 5-year period and to compare the outcome of open and laparoscopic surgery.


BACKGROUND
The value of laparoscopic treatment of gastroduodenal ulcers is still controversially debated because its superiority to conventional open surgery has not been established.


METHODS
From January 1996 to December 2001, 24 patients were treated laparoscopically and 31 patients underwent conventional open suture repair. The results of these patients were retrospectively reviewed.


RESULTS
There were 55 patients with a mean age of 55 years (range 18-92 years) who were eligible for the study. Patients with laparoscopic repair had a lower mean ASA score (2 vs. 2.9; P = 0.02) and a less severe Mannheimer peritonitis index (16.5 vs. 21; P = 0.00001) compared with patients with open repair. Three patients who were begun by the laparoscopic approach had to be converted to open surgery (12.5%). Three patients who underwent open repair died postoperatively (5.5%). There was no difference between treatment groups regarding operative time, morbidity, or postoperative hospital stay. The laparoscopic group required significantly fewer analgesics postoperatively (2.2 vs. 4 dosages; P = 0.04).


CONCLUSIONS
Laparoscopic treatment of perforated gastroduodenal ulcers is an effective treatment option and should be considered in suited patients for the initial approach.
Seelig
Matthias H
MH
Department of Surgery, University Hospital Muenster, Muenster, Germany. smseelig@gmx.net
Seelig
Stefanie K
SK
Behr
Christian
C
Schönleben
Klaus
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome