title: Laparoscopic treatment of perforated duodenal ulcer -- a multicenter study.
abstract: OBJECTIVE
  The aim of this study is to evaluate the results of the laparoscopic treatment of perforated duodenal ulcer performed in 6 Romanian surgical centres with experience in the field of laparoscopic surgery.
  
  
  METHODS
  Between 1996 and 2005, 186 patients with perforated duodenal ulcer were operated on in the centers participating in this retrospective study, all patients being ASA I-II. Thirty-nine patients (20.0%) presented mild peritonitis, 120 (64.5%) medium peritonitis and 27 (15.5%) severe (20.0%) simple suture was performed, in 110 (59.1%) suture with epiplonoplasty, for 1 (0.5%) only epiplonoplasty and 1 (0.5%) underwent excision of the perforation and suture.
  
  
  RESULTS
  The operative time was between 30-120 minutes, with an average of 75 minutes. No death was noted. Average hospitalization time was 6 days, with periods varying between 3 and 18 days. Postoperative complications included: 5 patients (2,6%) presented infections of the abdominal walls, 1 patient (0.5%) duodenal fistula, 1 patient (0.5%) intra-abdominal abscess, 1 patient (0.5%) a superior digestive hemorrhage by "mirrored ulcer" and 1 patient (0.5%) duodenal stenosis 6 months after operation. The patients were administered 50% less analgesics, used 70% less dressings, 30% less antibiotics and had 60% less complications in comparison with those operated by the classical approach.
  
  
  CONCLUSIONS
  The laparoscopic approach of perforated duodenal ulcer constitutes the first choice for patients without important co-morbidities, allowing a quick recovery and a significant reduction in the consumption of analgesics, antibiotics and dressing materials.
authors.affiliation: "Victor Babeş" University of Medicine and Pharmacy, Surgical Department 2, Timişoara, Romania. varcus.florian@yahoo.com
authors.forename: F
authors.initials: F
authors.lastname: Varcuş
authors.forename: F
authors.initials: F
authors.lastname: Lazăr
authors.forename: M
authors.initials: M
authors.lastname: Beuran
authors.forename: I
authors.initials: I
authors.lastname: Lica
authors.forename: C
authors.initials: C
authors.lastname: Turculeţ
authors.forename: Ea
authors.initials: E
authors.lastname: Nicolau
authors.forename: R
authors.initials: R
authors.lastname: Anghel
authors.forename: F
authors.initials: F
authors.lastname: Iordache
authors.forename: G
authors.initials: G
authors.lastname: Jinescu
authors.forename: C
authors.initials: C
authors.lastname: Murgu
authors.forename: D
authors.initials: D
authors.lastname: Vintilă
authors.forename: C
authors.initials: C
authors.lastname: Neacşu
authors.forename: C
authors.initials: C
authors.lastname: Bradea
authors.forename: St O
authors.initials: SO
authors.lastname: Georgescu
authors.forename: R
authors.initials: R
authors.lastname: Popescu
authors.forename: V
authors.initials: V
authors.lastname: Sârbu
authors.forename: D
authors.initials: D
authors.lastname: Sabău
authors.forename: A
authors.initials: A
authors.lastname: Dumitra
authors.forename: A
authors.initials: A
authors.lastname: Sabău
authors.forename: N
authors.initials: N
authors.lastname: Antonescu
authors.forename: A
authors.initials: A
authors.lastname: Coman
authors.forename: A
authors.initials: A
authors.lastname: Picu
authors.forename: V
authors.initials: V
authors.lastname: Binţinţan
authors.forename: C
authors.initials: C
authors.lastname: Ciuce
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000293:Adolescent; D000328:Adult; D004381:Duodenal Ulcer / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania; D013997:Time Factors; D016896:Treatment Outcome