Laparoscopic Surgery of Perforated Peptic Ulcer : Preliminary Report-การรักษาแผลกระเพาะอาหารทะลุโดยการ ผ่าตัดด้วยกล้อง : รายงานผู้ป่วย 5 ราย

Abstract

       Laparoscopic surgery is one of the most advanced technologies in abdominal surgery and became the procedure of choice for some conditions.  However, laparoscopic surgery is not widely used for perforated peptic ulcer which is an important surgical emergency.  

       This case report was to present outcomes and demonstrate surgical techniques of this procedure at Ratchaburi hospital.

       Between September 2004 and December 2007, laparoscopic surgery was performed in 5 patients (4 males and 1 female) with the mean age of 54.2 years (22-78), who were finally diagnosed with perforated peptic ulcers.  Two patients had perforated prepyloric ulcers whereas 3 patients had perforated duodenal ulcers.  All patients presented with sudden onset abdominal pains with average duration of 12.2 hours (3-24) prior to admissions.  Laparoscopic simple suture with omental graft was performed in all patients.  Mean operative time was 161 minutes (90-300) whereas mean length of stay was 8.4 days (7-10).  There was only one wound infection during postoperative period.  However, no mortality occurred during mean follow-up period of 8.4 weeks (1-22).  In conclusion; laparoscopic simple suture and omental graft is feasible, effective and safe alternative procedure in the management of perforated peptic ulcer.

Key words:  laparoscopy surgery, perforated peptic ulcer, simple closure