title: Laparoscopic and Open Surgical Treatment in Gastroduodenal Perforations: Our Experience.
abstract: BACKGROUND
  Peptic ulcer perforation (PPU) is a common surgical emergency and the mortality rate ranges 10% to 40%, especially in elderly patients. Laparoscopic repair achieved encouraging results.
  
  
  METHODS
  We enrolled patients performing surgical repair for PPU from January 2007 to December 2015 in our surgical unit. The aim of this retrospective observational study was to compare the results of PPU laparoscopic repair with open technique. The following characteristics of patients were evaluated: age, sex and American Society of Anesthesiologists classification. The site and the diameter of perforation were recorded: gastric, pyloric, duodenal, and the location on the anterior or posterior wall.
  
  
  RESULTS
  In total, 59 patients (39 males and 20 females) with a mean age of 58.85 years (±SD) were treated surgically. Laparoscopic repair was accomplished in 21 patients. The mean operative time for laparoscopic repair was 72 minutes (±SD), significantly shorter than open repair time (180 min ±SD). The results demonstrated that laparoscopic repair is associated with a shorter operative time, reduced postoperative pain (4.75 vs. 6.42) and analgesic requirements, a shorter hospital stay (7.5 vs. 13.1), and earlier return to normal daily activities.
  
  
  CONCLUSIONS
  Laparoscopic surgery minimizes postoperative wound pain and encourages early mobilization and return to normal daily activities. The benefit of early discharge and return to work may outweigh the consumable cost incurred in the execution of laparoscopic procedures.
  
  
  CONCLUSIONS
  Complications in both procedures are similar but laparoscopic procedure shows economic advantages for reducing postoperative hospital stay, postoperative pain, and for a good integrity of abdominal wall.
authors.affiliation: General Surgery Unit "V. Bonomo", Department of Emergency and Transplantation Organs, Hospital of Bari, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Laforgia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Balducci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carbotta
authors.forename: Antonio
authors.initials: A
authors.lastname: Prestera
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sederino
authors.forename: Giulia
authors.initials: G
authors.lastname: Casamassima
authors.forename: Marina
authors.initials: M
authors.lastname: Minafra
authors.forename: Pierluca
authors.initials: P
authors.lastname: Sallustio
authors.forename: Nicola
authors.initials: N
authors.lastname: Palasciano
mesh_terms: D004381:Duodenal Ulcer / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000601:surgery*