title: Duodenal ulcer perforation: a district hospital experience.
abstract: BACKGROUND
  Duodenal ulcer perforation still occurs frequently in the 21st century inspite of the wide availability of proton pump inhibitors.
  
  
  METHODS
  During 2005-2008, 34 patients underwent treatment of duodenal ulcer perforation at the University Hospital Lewisham, London. Laparoscopic or open repair of the perforation was used. In this study, we analysed the outcome of treatment in terms of complications, mortality and hospital stay with relevant to laparoscopy and open approach.
  
  
  RESULTS
  Ten patients underwent laparoscopic closure and the remaining 24 patients underwent laparotomy. The mean hospital stay for the laparoscopic group was 6.6 days and for open repair group was 12.8 days. There were two wound infection related to open approach and four patients died during the post operative period however the cause of death was not related to the procedure.
  
  
  CONCLUSIONS
  Laparoscopy has the advantage of avoiding a big incision and will enable the patient to get discharged home early. However, the only limiting factor is availability of expertise and competency of the surgeon.
authors.affiliation: Department of Surgery, University Hospital Lewisham, London, SE13 6LH. dr_durai@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Durai
authors.forename: A
authors.initials: A
authors.lastname: Razvi
authors.forename: A
authors.initials: A
authors.lastname: Uzkalnis
authors.forename: Ph C H
authors.initials: PC
authors.lastname: Ng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications* / Q000601:surgery*; D005260:Female; D006767:Hospitals, District; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D055815:Young Adult