Comparing the clinical efficacy between laparoscopic and open omental patch repair for perforated peptic ulcer / 中国医师进修杂志

ABSTRACT

Objective To investigate the clinical efficacy of laparoscopic versus open omental patch repair for perforated peptic ulcer. Methods One hundred and twenty-seven patients who underwent omental patch repair for perforated peptic ulcer were analyzed retrospectively. There were 74 cases in the laparoscopic repair group (LR group) and 53 cases in the open repair group (OR group) respectively. Operative time, intraoperative blood loss,postoperative pain at 1 d and 3 d.time to first flatus and resumption of diet, time to drainage removal,surgical site infections (wound infection and intra-abdominal abscess),systemic complications and length of postoperative hospital stay were compared. Results LR group experienced less intraoperative blood loss[(32.7 ±25.6) ml], lower postoperative pain at 3 d[(2.8 ±1.5) scores], earlier time to first flatus [ (25.8 ± 20.1) h] and resumption of diet [ (2.7 ±2.1) d ], shorter time to drainage removal [(2.0±1.5) d], less wound infection (0) and shorter hospital stay[(4.8 ±2.3) d] than those in OR group [(53.2±30.0) ml, (36.9±27.9) h, (3.7±2.0) scores, (3.6±2.3) d,(2.9±2.2) d,9.4%(5/53), (6.6±4.0) d](P< 0.01 or <0.05). There were no significant differences in operative time,postoperative pain at 1 d, incidence of intra-abdominal abscess and systemic complications between the two groups. There were no suture-site leakage, reoperation and death in two groups. Conclusions Laparoscopic omental patch repair for perforated peptic ulcer is safe and efficacious. It has significant advantages over open approach with respects of less postoperative pain,earlier return of bowel function,less wound infection and shorter hospital stay.