English abstract
kground: Aim of this study was to compare the result of
open and laparoscopic repair of perforated peptic ulcers in terms
of operation time, postoperative pain, hospital stay, and wound
infection.
Methods: Clinical notes of 152 patients who underwent the
operative closure of perforated peptic ulcers from 1996 to 2006
were available for study. All patients were offered laparoscopic
approach from 1998 onward. Repair was done using omentum
patch. Open approach was used in 57 patients and laparoscopic
in 95 patients. Results were analyzed in terms of requirement
of analgesia, hospital stay, return to work, complications, and
mortality.
Results: Closure was successful in all cases using omentum patch.
There was no conversion to open in laparoscopic group. The mean
operation time was less in laparoscopic versus open (P<0.001).
The mean number of analgesic injection given were 3 and the
hospital stay was 4 days in laparoscopy, the corresponding figure in
laparotomy were 6 and 9 respectively (P<0.001). Total numbers of
complication in laparoscopic repair were 9 compared to 35 in open
(P=0.011). Two patients died in each group. Incidental significant
incidences of perforations was observed in men (P<0.001), fasting
during Ramadan (P<0.001), smokers (P<0.001), past history of
peptic ulcer disease (P=0.007), and use of non-steroidal antiinflammatory drugs (P=0.035).
Conclusion: Compared to open approach, laparoscopic repair
required shorter operation time, lesser analgesia, had fewer
complications, shorter hospital stays and early return to work.
