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Laparoscopic repair of perforated peptic ulcer: a multicenter, propensity score matching analysis.
Kim, Chang Woo; Kim, Jong Wan; Yoon, Sang Nam; Oh, Bo Young; Kang, Byung Mo.
Affiliation
  • Kim CW; Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
  • Kim JW; Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
  • Yoon SN; Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • Oh BY; Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • Kang BM; Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, 24253, Chuncheon, Korea. kbm0728@yahoo.co.kr.
BMC Surg ; 22(1): 230, 2022 Jun 16.
Article in En | MEDLINE | ID: mdl-35710415
ABSTRACT

BACKGROUND:

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 PPU.

METHODS:

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

RESULTS:

Among the 598 patients included in the analysis, OS 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 (24.6% LS group vs. 31.7% OS group, p = 0.131). However, postoperative length of hospital stay (10.03 vs. 12.53 days, respectively, p = 0.003) and postoperative time to liquid intake (3.75 vs. 5.26 days, p < 0.001) were shorter in the LS group.

CONCLUSIONS:

LS resulted in better functional recovery than OS and can be safely performed for treatment of PPU. When performed by experienced surgeons, LS is an alternative option, even for hemodynamically unstable patients.
Subject(s)
Key words

Full text: 1 Database: MEDLINE Main subject: Peptic Ulcer Perforation / Laparoscopy Type of study: Etiology_studies / Observational_studies Limits: Humans Language: En Year: 2022 Type: Article

Full text: 1 Database: MEDLINE Main subject: Peptic Ulcer Perforation / Laparoscopy Type of study: Etiology_studies / Observational_studies Limits: Humans Language: En Year: 2022 Type: Article