[Feasibility of laparoscopic treatment of duodenal ulcers: results of 160 cases].
OBJECTIVE
The objective of this study is to evaluate the feasibility, efficacy and safety of laparoscopic repair for perforated duodenal ulcer.


METHODS
One hundred and sixty patients were treated by coelioscopic procedure for a perforated duodenal ulcer. The procedure consists on a suture of perforated ulcer associated with a peritoneal lavage. A medical treatment of Helicobacter pylori associated with an inhibitor of the protons pomp was conducted.


RESULTS
The coelioscopic procedure permitted to confirm the diagnostic of perforated duodenal ulcer in all cases. A simple suture of the ulcer was done in 155 cases. The conversion was compulsory in 5 cases, because of difficulties of the peritoneal lavage in 2 cases, a bleeding associated with perforation of the ulcer in one case and associated stenosis in 2 cases. Mean duration was 90 min (extremes 50 - 120 min). Complications occur in 3,1%. They were post - operative peritonitis in 3 cases and duodenal fistulae in 2 cases. All patients were reviewed at 16 months. A recurrence, either clinical or endoscopic occurs in 4 cases because of no adhesion to medical treatment.


CONCLUSIONS
Coelioscopic treatment of perforated duodenal ulcer is a safe and efficacy method. It permits to avoid potential septic and parietal complications of laparotomy. The actual efficacy of medical treatment mustn't allow place to the radical treatment of ulcerous illness.
Khelifi
Slim
S
Service de Chirurgie Générale. Hôpital Habib Thameur.
Ben Ali
Ali
A
Bouhafa
Ahmed
A
Zghidi
Souheil
S
Ben Maamer
Anis
A
Jaoua
Hazem
H
Oueslati
Abdelaziz
A
Ouertani
Fethi
F
Cherif
Abderraouf
A
D000328:Adult; D004381:Duodenal Ulcer / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010439:Peptic Ulcer Perforation / Q000601:surgery; D012189:Retrospective Studies