A Clinical Study on the Usefulness of Laparoscopic Repair for Perforated Duodenal Ulcer

Atsushi Nagashima, Hiroshi Yoshii, Mitsuhide Kitano, Masakazu Doi, Shinobu Hayashi, Masahiro Motegi and Syuuzo Yamamoto

Department of Surgery, Saiseikai Kanagawaken hospital

Laparoscopic closure of perforated duodenal ulcer was performed in forty patients between May 1992 and December 1999. This report compares the forty patients who underwent laparoscopic closure (LC group) and another forty-nine patients who underwent conventional open closure (OC group) between January 1988 and April 1992. Patient background was the same in both groups. Laparoscopic closure took significantly longer than open closure (p<0.01), but significantly less analgesic was required after laparoscopic closure than after open closure (p<0.01). Significantly fewer days resumption of oral feeding and significantly fewer hospital days after laparoscopic closure required than after open closure (p<0.01). The morbidity rate in the LC group was significantly lower than in the OC group (p<0.05). There were no significant differences in mortality rate, reoperation rate or rate of recurrence of duodenal ulcer between LC group and OC group. These results suggest that laparoscopic closure is not invasive and that it accelerates patient's recovery following discharge from the hospital. In conclusion, laparoscopic closure appears to be an effective procedure for the treatment of perforated duodenal ulcer.

Key words
perforated duodenal ulcer, laparoscopic surgery, omental patch repair

Reprint requests
Atsushi Nagashima Department of Surgery, Saiseikai Kanagawaken Hospital 6-6 Tomiya-cho, Kanagawa-ku, Yokohama, 221-8601 JAPAN

Accepted
September 20, 2000

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