Laparoscopic repair of perforated gastroduodenal ulcer by running suture.
OBJECTIVE
Perforated gastroduodenal ulcer represents an emergency situation that requires immediate surgical intervention. Laparoscopic ulcer repair is a feasible and safe procedure, especially in cases of a short duration of ulcer perforation and good clinical condition. However, to be well accepted as a treatment modality, an endoscopic procedure should be as simple as possible. We describe a technique that does not require intra-corporal or extra-corporal knotting.


METHODS
Over a 4-year period, we performed 786 diagnostic laparoscopies for various, acute abdominal conditions. We identified 20 gastroduodenal perforations. All ulcers were closed with a one-row running suture (Lahodny) and controlled radiologically on the third postoperative day.


RESULTS
Three different surgeons performed the surgeries. There were no conversions to open surgery. Median operating time was 50 min, and median hospital stay was 9 days. We observed no insufficiency, no wound infection, and no stenosis or persisting peritonitis.


CONCLUSIONS
The closure of perforated gastric ulcers with the Lahodny suture is safe and simple to perform.
Köninger
Jörg
J
Abteilung für Allgemein- und Viszeralchirurgie, Krankenhaus Bietigheim, Riedstrasse 12, 74321, Bietigheim-Bissingen, Germany, Joerg.Koeninger@med.uni-heidelberg.de
Böttinger
Peter
P
Redecke
Jens
J
Butters
Michael
M
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures; D004381:Duodenal Ulcer / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D005260:Female; D016481:Helicobacter Infections / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D011446:Prospective Studies; D013276:Stomach Ulcer / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D013536:Suture Techniques