title: Outcome of laparoscopic repair of perforated duodenal ulcers.
abstract: BACKGROUND
  Laparoscopic simple closure (LSC) coupled with Helicobacter pylori eradication is a well-recognised treatment for perforated duodenal ulcers. This study aimed to evaluate its safety and efficacy.
  
  
  METHODS
  This was a retrospective cohort study conducted on patients who underwent LSC of perforated duodenal ulcers from January 2002 to December 2009. Patients were stratified according to the American Society of Anesthesiologist classification and Boey's risk score.
  
  
  RESULTS
  Of the 213 patients, 22 (10.3%) were excluded as they required conversion to open surgery. 191 (89.7%) patients who underwent successful laparoscopic repair were included in the study. The median age of the patients was 39 (range 19-73) years, and the majority were male (n = 180, 94%). Median duration of pre-hospital symptoms was eight hours and median time from admission to surgery was six hours. Median operative time was 65 minutes and median hospital stay was five days. Ten patients (median age 53.5 years) required intensive care unit admission. Two patients developed leakage from the suture line - one required re-exploration and the other was managed conservatively. Four patients had intra-abdominal abscesses - one required re-exploration, while three were managed by percutaneous radiological drainage. One patient developed pneumonia and one had pulmonary embolism. There were no surgical site infections. All patients were followed up as surgical outpatients (median duration 36 days). None of the patients required definitive surgery. There was one death in the cohort.
  
  
  CONCLUSIONS
  LSC of perforated duodenal ulcers is a reliable, safe and minimally invasive procedure that has low morbidity.
authors.affiliation: Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, PO 3050, Doha, Qatar. dr.johary@hotmail.com
authors.forename: Hisham
authors.initials: H
authors.lastname: Aljohari
authors.forename: Hassan
authors.initials: H
authors.lastname: Althani
authors.forename: Gameela
authors.initials: G
authors.lastname: Elmabrok
authors.forename: Khairy
authors.initials: K
authors.lastname: Hajaji
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Taha
mesh_terms: D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult