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2016, Number 2

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Cir Gen 2016; 38 (2)

Minimally invasive approach to perforated peptic ulcer at the General Hospital “Dr. Manuel Gea González”

Rodríguez-Espínola G, Trejo-Ávila ME, Valenzuela-Salazar C, Solórzano-Vicuña D, Romero-Loera LS, Moreno-Portillo M
Full text How to cite this article 10.35366/69216

DOI

DOI: 10.35366/69216
URL: https://dx.doi.org/10.35366/69216

Language: Spanish
References: 8
Page: 72-77
PDF size: 617.06 Kb.


Key words:

Perforated peptic ulcer, laparoscopic surgery, primary closure, intraoperative endoscopy.

ABSTRACT

Introduction: Minimally invasive approach of peptic ulcer disease is an attractive alternative for repairing perforations, peritoneal lavage, and avoiding complications associated with the open surgery approach. Material and methods: We reviewed records of patients with perforated peptic ulcer treated with laparoscopic surgery from August 2014 to December 2015 in our hospital. Results: We included 13 patients in our study, all of which were approached initially with laparoscopic surgery. The perforation was repaired with primary closure (76.9%) with "Gea" extracorporeal sliding knot (84.6%), with omental patch (76.9%). We used intraoperative endoscopy in some cases (46.1%) for complementary diagnosis, biopsies and review of the closure. The peritoneal cavity was thoroughly irrigated with normal saline solution in 53.8%. All surgeries finished laparoscopically. The mean operating time was 103 min. In 92.3%, we started enteral nutrition before 72 hrs. The mean hospital stay was 5.8 days. None of the patients required reintervention. Conclusions: In our study, we observed the possibility of approaching all perforated peptic ulcers laparoscopically, with good results at short follow-up and few postoperative complications.


REFERENCES

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  2. Byrge N, Barton RG, Enniss TM. Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis. Am J Surg. 2013; 206: 957-963.

  3. Lau WY, Leow CK. History of perforated duodenal and gastric ulcers (surgical history). World J Surg. 1997; 21: 890-896.

  4. Rojas O, González J, Ochoa J. Manejo laparoscópico de las úlceras pépticas perforadas. Rev Mex Cir Endoscop. 2004; 5: 134-138.

  5. González-Castro L, González-Acosta MA, Manjarrez-Cuenca JA. Abordaje laparoscópico de úlcera gástrica perforada. Rev Fac Med. 2011; 54: 41-45.

  6. Bhogal R, Athwal R, Durkin D, Deakin M, Cheruvu C. Comparison between open and laparoscopic repair of perforated peptic ulcer disease. World J Surg. 2008; 32: 2371-2374.

  7. Sanabria A, Villegas MI, Morales Uribe CH. Laparoscopic repair for perforated peptic ulcer disease. Cochrane Database Syst Rev. 2013; (2): CD004778. doi: 10.1002/14651858.CD004778.pub3.

  8. Wang Y, Hsieh C, Lo H, Su L. Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers. World J Surg. 2014; 38: 1917-1921.




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Cir Gen. 2016;38