title: Laparoscopic treatment of gastroduodenal perforations: comparison with conventional surgery.
abstract: BACKGROUND
  Laparoscopic techniques have been proposed as an alternative to open surgery for the treatment of peptic ulcer perforation. This study compared the outcome of laparoscopic and open approaches for the repair of gastroduodenal perforations.
  
  
  METHODS
  A retrospective review was conducted with 134 consecutive patients treated for gastroduodenal perforations. These patients included 122 with perforated duodenal ulcers, 10 with perforated gastric ulcers, and 2 with iatrogenic duodenal perforations. Whereas 68 patients were treated laparoscopically, 66 patients underwent conventional (open) surgery.
  
  
  RESULTS
  Laparoscopic repair was successful in 65 cases (96 %). The mean operating time was shorter with the laparoscopic technique (68 vs 59 min), but the difference was not significant. The duration of postoperative nasogastric aspiration and time to resumed oral intake were shorter in the laparoscopic group (2.6 vs 4.1 days and 4.4 vs. 5.2 days, respectively; p = 0.043). The postoperative analgetic requirements, and overall complications rate were significantly lower after laparoscopic surgery (p = 0.03 and p = 0.004, respectively). There was no statistically significant difference in hospital stay (5.1 vs 6.1 days) or mortality rate between the two procedures.
  
  
  CONCLUSIONS
  Laparoscopic repair of gastroduodenal perforations is a safe alternative treatment offering certain significant short-term advantages.
authors.affiliation: Department of Surgery A, Soroka University Hospital, Post Office Box 151, Beer Sheva 84101, Israel. borkirsh@bgumail.bgu.ac.il
authors.forename: B
authors.initials: B
authors.lastname: Kirshtein
authors.forename: M
authors.initials: M
authors.lastname: Bayme
authors.forename: T
authors.initials: T
authors.lastname: Mayer
authors.forename: L
authors.initials: L
authors.lastname: Lantsberg
authors.forename: E
authors.initials: E
authors.lastname: Avinoach
authors.forename: S
authors.initials: S
authors.lastname: Mizrahi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004378:Duodenal Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D012189:Retrospective Studies