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Arch Surg. 1999 Aug;134(8):845-8; discussion 849-50.

Laparoscopic repair of perforated duodenal ulcers: outcome and efficacy in 30 consecutive patients.

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  • 1Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA.

Abstract

HYPOTHESIS:

Laparoscopic management of perforated duodenal ulcers is safe and effective.

DESIGN:

Prospective nonrandomized controlled trial.

SETTING:

Tertiary care academic center.

PATIENTS AND METHODS:

Between October 1993 and October 1997, 30 patients underwent laparoscopic Graham patch repair of perforated duodenal ulcers and 16 had an open repair.

MAIN OUTCOME MEASURES:

Morbidity, operating time, analgesic requirements, length of hospital stay, and time to return to work.

RESULTS:

There was no difference in morbidity between the 2 groups. Operating time was longer in the laparoscopy group (106 vs. 63 minutes; P = .001). Patients with shock on admission or symptoms for more than 24 hours had a higher conversion rate (P<.05). The laparoscopy group required fewer analgesics, had a shorter stay, and a quicker recovery.

CONCLUSIONS:

Laparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.

PMID:
10443807
[PubMed - indexed for MEDLINE]
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