Laparoscopic Surgery for Diseases of the Stomach and the Duodenum

Masahiro Ohgami

Department of Surgery, School of Medicine, Keio University

Laparoscopic surgery has been introduced for the treatment of perforated duodenal ulcer and early gastric cancer in our department. Five patients with perforated duodenal ulcers have been successfully treated by the laparoscopic omental patch method. Peritoneal irrigation with 5-10 L of warmed saline was carried out, and an omental patch was applied by laparoscopic continuous suture. The postoperative courses were uneventful and the ulcers has been well controlled by an H₂ blocker. For early gastric cancer, two different types of laparoscopic surgery have been performed. If the lesion is located at the anterior wal or the greater curvature of the stomach, laparoscoic wedge resection of the stomach by the lesion lifting method is applied. If the lesion is located at the posterior wall, the lesser curvature of the stomach, or near the cardia or pylorus, laparoscopic intragastric mucosal resection by Ohashi's method is applied. Ten patients with early gastric cancer which were preoperatively diagnosed as mucosal cancer have been successfully treated by these laparoscopic surgical methods. Postoperative courses were all uneventful, and histological examination reveald that the cancerous infiltration was within the mucosal layer, and that there was a sufficient surgical margin.

Key words
laparoscopic surgery, duodenal ulcer, early gastric cancer

Reprint requests
Masahiro Ohgami Department of Surgery, School of Medicine, Keio University
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
May 11, 1994

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