A retrospective analysis of laparoscope versus open repair on treating upper gastrointestinal ulcer perforation / 中国医师进修杂志

ABSTRACT

ObjectiveTo evaluate the effect of laparoscope and open repair on treating upper gastrointestinal(UGI) ulcer perforation.MethodsRetrospective analysis was performed in consecutive series of 143 patients undergoing UGI ulcer perforation repairing.Among the total 143 patients,98 cases underwent laparoscope repair(laparoscope group),45 cases were with open repair (open group).The operation methods included either simple interrupted suture or pedicled omental patch.Postoperative management of triple therapy included proton pump inhibitor,β -lactam antibiotics and arilin was conducted.Therapeutic effects were compared between two groups.ResultsOperating time in laparoscope group was significantly longer than that in open group [ ( 83.88 ± 19.67 ) min vs.( 63.33 ± 12.06) min,P ＜ 0.01 ].Time of passage of gas by anus,hospital stay,cost of hospitalization and postoperative dosage of opiates in laparoscope group were significantly lower than those in open group [ (29.45 ± 9.24) h vs.( 46.40 ± 49.21 )h,(6.92 ± 1.06) d vs.(7.71 ± 2.48 ) d,(6929.39 ± 832.40) yuan vs.(7546.67 ± 1393.92) yuan,(5.7 ±8.3 ) mg vs.( 10.9 ± 9.5 ) mg,P＜ 0.01 ].There was no significant difference between two groups in perforated diameter,perforated position and flushing dose of abdominal cavity (P＞ 0.05 ).The rate of complication was 14.29％ (14/98) in laparoscope group,while 26.67％ (12/45) in open group,there was no significant difference between two groups (P＞ 0.05 ).ConclusionsLaparoscope repair of UGI ulcer perforation is a safe and feasible procedure compared with open repair.Although operating time of laparoscope repair is longer than open repair,the rate of complication does not increase.