Laparoscopic and open approach in perforated peptic ulcer.
OBJECTIVE
To improve the perioperative course and quality of life of the patients with perforated peptic ulcer, we investigated the conversion risk factors in laparoscopic simple closure and omental patch repair for perforated peptic ulcer.


METHODS
A total of 71 patients with a mean age of 46 years (rage, 17-81 years) was examined, and their clinical data was recorded and analyzed.


RESULTS
The postoperative durations of nasogastric tube insertion, ileus, analgesic requirement, resuming diet, and hospital stay were shorter in the patients with laparoscopic simple closure than in those with open simple closure and omental patch repair. Univariate regression analysis revealed that the age, American Society of Anesthesiologist classification, presence of concomitant disease, and length of free air or fluid collection shown in abdominal computerized tomography significantly correlated with the conversion of laparoscopic simple closure and omental patch repair to open simple closure and omental patch repair.


CONCLUSIONS
These conversion factors are useful to achieve appropriate surgical treatments for perforated peptic ulcer.
Tsumura
Hiroaki
H
Department of Surgery, Hiroshima Municipal Funairi Hospital, Hiroshima University School of Medicine, Hiroshima, Japan. tuntun1234@hotmail.com
Ichikawa
Toru
T
Hiyama
Eiso
E
Murakami
Yoshiaki
Y
D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000209:etiology / Q000601:surgery*; D005260:Female; D016481:Helicobacter Infections / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques