English abstract
Objectives: Giant perforation (size > 2 cm) is a catastrophic complication of peptic ulcer
disease, which is difficult to repair and leads to postoperative leakage and 60% morbidity
and 48.2% mortality rates. The objective of this meta-analysis was to compare the
postoperative outcomes of omental plugging and omentopexy in the treatment of giant
ulcer perforation. Methods: The dataset was defined by searching for articles published
until December 2020 from PubMed, Embase, Google Scholar, and the Cochrane database.
The search terms included were giant peptic ulcer, peptic ulcer perforation, omentopexy,
and omental plug. The data analysis included a study published in English that evaluated
the surgical outcomes of omental plugging and omentopexy in the management of giant
peptic ulcer perforation patients. Meta-analysis was performed using Review Manager
software version 5.4.1. Results: A total of 175 articles were identified during the initial
search. After review, eight articles were suitable for inclusion in the meta-analysis. A
total of 367 patients were included in the final analysis. The findings demonstrate that
when compared to the omentopexy group, the omental plugging technique significantly
reduced overall postoperative complications (odds ratio (OR) = 0.29, 95% CI: 0.18–
0.47, p = 0.0001) and bile leakage rate (OR = 0.18, 95% CI: 0.07–0.46, p = 0.0003),
resulting in a significantly lower postoperative mortality rate (OR = 0.35, 95% CI:
0.17–0.69, p = 0.003). However, there was no significant difference in intraabdominal
collection, respiratory tract, and wound infection rates between each surgical treatment
group. Conclusions: Omental plugging is a simple surgical procedure associated with
fewer postoperative complications and mortality than omentopexy. This technique is a
safe surgical treatment option for peptic ulcer perforations > 2 cm.
