Laparoscopic surgery better than open surgery in treating perforated peptic ulcers: study

Perforated peptic ulcer (PPU) is a common emergency condition requiring surgery using laparoscopy or open repair of the perforated site.

The aim of this study was to assess the role of laparoscopic surgery (LS) based on the safety and efficacy for Perforated peptic ulcers.

Medical records of the consecutive patients who underwent laparoscopic surgery or open surgery (OS) for Perforated peptic ulcers at five hospitals between January 2009 and December 2019 were retrospectively reviewed. After propensity score matching, short-term perioperative outcomes were compared between laparoscopic surgery and open surgery in selected patients.

Results:

• Among the 598 patients included in the analysis, open surgery was more frequently performed in patients with worse factors, including older age, a higher American Society of Anesthesiologists score, more alcohol use, longer symptom duration, a higher Boey score, a higher serum C-reactive protein level, a lower serum albumin level, and a larger-diameter perforated site.
• After propensity score matching, 183 patients were included in each group; variables were well-balanced between groups.
• Postoperative complications were not different between groups
• However, postoperative length of hospital stays and postoperative time to liquid intake were shorter in the laparoscopic surgery group.

Thus, laparoscopic surgery resulted in better functional recovery than open surgery and can be safely performed for the treatment of Perforated peptic ulcers. When performed by experienced surgeons, laparoscopic surgery is an alternative option, even for hemodynamically unstable patients.

Reference:

Laparoscopic repair of perforated peptic ulcer: a multicenter, propensity score matching analysis by Chang Woo Kim et al. published in the BMC Surgery

https://doi.org/10.1186/s12893-022-01681-1

Keywords:

Laparoscopic, repair, perforated, peptic, ulcer, multicenter, propensity, score, matching, analysis, Chang Woo Kim, Jong Wan Kim, Sang Nam Yoon, Bo Young Oh, Byung Mo Kang, Peptic ulcer, Peptic ulcer perforation, Laparoscopy, Complication, Propensity score, BMC Surgery