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| |  SAGES: Laparoscopic Repair of Perforated Peptic Ulcer Has Been Successful By Maggie Schwarz Special to DG News NEW YORK, NY -- March 19, 2002 -- Laparoscopic repair of perforated peptic ulcers carries acceptable morbidity and mortality and is not painful, researchers reported here at the 8th World Congress of Endoscopic Surgery (SAGES). W.T. Siu and colleagues at Pamela Youde Nethersole Eastern Hospital, Hong Kong, China, presented results in 148 men and 32 women, ages 16 to 85 years (mean, 54.6 years). A total of 142 patients had perforated duodenal ulcers, 27 had pre-pyloric ulcers, and 11 had gastric ulcers. Patients with history of upper abdominal surgery, concomitant evidence of ulcer bleeding or gastric outlet obstruction were excluded from the study, and those with clinically sealed off perforation were treated with a conservative technique. Twenty-eight laparoscopic surgeries were converted to open surgery (15.6 percent). These were for nine perforated non-juxtapyloric gastric ulcers, 12 large perforations, one bleeding ulcer, three unidentifiable perforations, and three cases of poor exposure. The average operating time was 46.3 minutes (range, 10 to 150 minutes). An average of one dose of intramuscular pethidine was given postoperatively for analgesia. Three leakages from the repaired site required reoperation. One patient developed postoperative duodenal ulcer bleeding. One patient whose laparoscopic surgery was converted to open surgery experienced a complication of port site herniation. Four patients with American Society of Anesthesia physical status IV died postoperatively. The researchers concluded that laparoscopic repair of perforated peptic ulcer is safe and carries an acceptable rate of morbidity and mortality. Moreover, laparoscopic ulcer repair is not painful.
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