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- N Katkhouda, E Mavor, R J Mason, G M Campos, A Soroushyari, and T V Berne.
- Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA.
- Arch Surg Chicago. 1999 Aug 1; 134 (8): 845-8; discussion 849-50.
HypothesisLaparoscopic management of perforated duodenal ulcers is safe and effective.DesignProspective nonrandomized controlled trial.SettingTertiary care academic center.Patients And MethodsBetween October 1993 and October 1997, 30 patients underwent laparoscopic Graham patch repair of perforated duodenal ulcers and 16 had an open repair.Main Outcome MeasuresMorbidity, operating time, analgesic requirements, length of hospital stay, and time to return to work.ResultsThere was no difference in morbidity between the 2 groups. Operating time was longer in the laparoscopy group (106 vs. 63 minutes; P = .001). Patients with shock on admission or symptoms for more than 24 hours had a higher conversion rate (P<.05). The laparoscopy group required fewer analgesics, had a shorter stay, and a quicker recovery.ConclusionsLaparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.
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