title: [Laparoscopy for perfored duodenal ulcer : conversion and morbidity factors: retrospective study of 290 cases].
abstract: BACKGROUND
  feasibility and advantages of laparoscopic approach in performed duodenal ulcer have no longer to be demonstrated. Laparoscopic suture and peritoneal cleaning expose to a conversion rate between 10 and 23%. However less than laparotomy, morbidity of this approach is not absent.
  
  
  OBJECTIVE
  This study aim to analyze factors exposing to conversion after laparoscopic approach of perforred duodenal ulcer. We also aim to define the morbidity of this approach and predictive factors of this morbidity Methods: Retrospective descriptive study was conducted referring all cases of perforated duodenal ulcer treated laparoscopically over a period of ten years, running from January 2000 to December 2010. All patients were operated by laparoscopy with or without conversion. We have noted conversion factors. A statistical analysis with logistic regression was performed whenever we have sought to identify independent risk factors for conversion verified as statistically significant in univariante. The significance level was set at 5%. Analytic univariant and multivariant study was performed to analyze morbidity factors.
  
  
  RESULTS
  290 patients were included. The median age was 34ans.T he intervention was conducted completely laparoscopically in 91.4% of cases. The conversion rate was 8.6%. It was selected as a risk factor for conversion: age> 32 years, a known ulcer, progressive pain, renal function failure, a difficult peritoneal lavage and having a chronic ulcer. Postoperative morbidity was 5.1%. Three independent risk factors of surgical complications were selected: renal failure, age> 45 years, and a chronic ulcer appearance.
  
  
  CONCLUSIONS
  Laparoscopic treatment of perforred duodenal ulcer expose to a conversion risk. Morbidity is certainly less than laparotomy and a better Knowledge of predictif's morbidity factors become necessary for a better management of this disease.
authors: Sadreddine
authors: S
authors: Ben Abid
authors: Zeineb
authors: Z
authors: Mzoughi
authors: Mohamed Amine
authors: MA
authors: Attaoui
authors: Ghofrane
authors: G
authors: Talbi
authors: Nafaa
authors: N
authors: Arfa
authors: Lassaad
authors: L
authors: Gharbi
authors: Mohamed Taher
authors: MT
authors: Khalfallah
mesh_terms: D000328:Adult; D061887:Conversion to Open Surgery / Q000009:adverse effects / Q000706:statistics & numerical data*; D004381:Duodenal Ulcer / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D009017:Morbidity; D010439:Peptic Ulcer Perforation / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D017211:Treatment Failure