2016, Number 2
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
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ABSTRACTIntroduction: 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.