title: Laparoscopic Repair for Perforated Peptic Ulcer in Children.
abstract: IntroductionA perforated peptic ulcer (PPU) is a rare but major complication of gastroduodenal peptic ulcer disease. Literature is scarce on this subject in the pediatric population and most articles describe a surgical treatment by laparotomy. We aim to review all our cases of pediatric PPU treated over the past 16 years and compare these to literature to deduce potential benefits and disadvantages regarding laparoscopic treatment of PPU in children.Materials and MethodsA retrospective study of all cases of PPU treated at the Lenval Hospital in Nice (France) and the Queen Fabiola University Hospital for Children in Brussels (Belgium) between 1998 and 2015 was performed.ResultsA total of five children were treated for PPU (2 females). The average age was 11 years (range, 3-17). All of them were surgically treated with laparoscopic simple suture of the perforation and placement of an omental patch. There were no mortalities, no conversions, and no extra-abdominal complications or wound dehiscences. Mean operating time was 78.6 minutes (range, 70-115 minutes). Mean duration of intravenous treatment was 6 days (range, 4-12 days). One reintervention was performed for abdominal infection. In one patient, an abdominal drain was left in place for 2 days. The mean time before refeeding was 3.4 days (range, 3-4 days) and mean length of stay was 12 days (range, 7-30 days).ConclusionLaparoscopic repair is safe and feasible for PPU and should be the gold standard for treatment of PPU in children.
authors.affiliation: Department of Pediatric Surgery, Hopital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Helena
authors.initials: H
authors.lastname: Reusens
authors.affiliation: Department of Pediatric Surgery, Hopital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Martine
authors.initials: M
authors.lastname: Dassonville
authors.affiliation: Department of Pediatric Surgery, Hopital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Henri
authors.initials: H
authors.lastname: Steyaert
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D009852:Omentum / Q000637:transplantation; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome