• Med Princ Pract · Jan 2019

    Laparoscopy in Acute Care Surgery: Repair of Perforated Duodenal Ulcer.

    • Mohammad H Jamal, Abdulazeez Karam, Nourah Alsharqawi, Abdulla Buhamra, Ibtesam AlBader, Jasem Al-Abbad, Mohammad Dashti, Yaser B Abulhasan, Husain Almahmeed, and Salman AlSabah.
    • Department of Surgery, Kuwait University, Kuwait City, Kuwait, mohammad.jamal@mail.mcgill.ca.
    • Med Princ Pract. 2019 Jan 1; 28 (5): 442-448.

    IntroductionThe use of laparoscopic management as a first choice for the treatment of duodenal perforation is gaining ground but is not routine in many centers. In this report, we aim to report our experience with laparoscopy as the first approach for the repair of duodenal perforation.Materials And MethodsThis is a retrospective review of patients during our initial experience with the use of laparoscopy for the treatment of duodenal perforation between 2009 and 2013.ResultsA total of 100 patients underwent management of duodenal perforation. Laparoscopy was attempted initially in 76 patients (76%) and completed in 64 patients (64%). The length of hospital stay was shorter in the laparoscopic group (mean 2.6) than in the open group (mean 3.1) (p = 0.008). Complications developed in 14 patients (20%). There was a tendency towards fewer admissions to intensive care, less acute kidney injuries, and less acute respiratory distress syndrome in the laparoscopic group. In patients who underwent laparoscopic surgery, the chances of uneventful recovery were 4.3 times higher than in those patients who underwent open surgery (95% CI 1.3-13.5, p = 0.014).ConclusionsLaparoscopy in the treatment of perforated duodenal ulcer is safe and can be utilized as a routine approach for the treatment of this pathology.© 2019 The Author(s) Published by S. Karger AG, Basel.

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