Alternative laparoscopic management of perforated peptic ulcers

  title={Alternative laparoscopic management of perforated peptic ulcers},
  author={D Urbano and Massimo Rossi and Paolo De Simone and Pasquale Berloco and Dario Alfani and Raffaello Cortesini},
  journal={Surgical Endoscopy},
Surgery—namely, suture closure-is still the treatment of choice for perforated peptic ulcers, despite the proven efficacy of Taylor's conservative approach. Such conservative management, however, has been proven less effective in high-risk patients and those with perforations more than 12 h old. Here we suggest alternative laparoscopic treatments for perforated peptic ulcers.We have treated laparoscopically six patients (one F, five M; mean age 57.6 years; range 31–81 years); the mean duration… 

Laparoscopic Management of Perforated Peptic Ulcer: Simple Closure or Something More?

Laroscopic treatment of perforated peptic ulcer is technically feasible and safe when performed by experienced surgeons and in certain cases more definitive procedures may achieve better long-term results.

Laparoscopic Suture Closure of Perforated Duodenal Peptic Ulcer

The results of this study show the feasibility of the laparoscopic approach for perforated peptic ulcer repair, with acceptable mortality and morbidity rates.

Laparoscopic management of perforated peptic ulcer with single suture or single suture and modified taylor procedure

Laparoscopic repair of a perforated peptic ulcer is a relatively safe and simple method, when performed by an experienced laparoscopic surgeon, and offers a valid alternative to the permanent medical therapy of a gastroduodenal ulcer.

Laparoscopic closure of perforated duodenal ulcer

This procedure is safe and efficient; however, further study of its long-term effectiveness and comparability to existing therapy is still needed.

Laparoscopic correction of perforated peptic ulcer: first choice? A review of literature

There are good arguments that laparoscopic correction of PPU should be first treatment of choice, and a Boey score of 3, age over 70 years, and symptoms persisting longer than 24 h are associated with higher morbidity and mortality and should be considered contraindications for Laparoscopic intervention.

Gasless laparoscopic treatment of perforated duodenal ulcer: a case report.

Gasless laparoscopic repair of perforated duodenal ulcer is proved to be another abdominal procedure that can be carried out with all the technical and anesthesiological advantages of gasless minimally invasive surgery.

Laparoscopic Repair for Perforated Peptic Ulcer: A Randomized Controlled Trial

Laparoscopic repair of perforated peptic ulcer is a safe and reliable procedure associated with a shorter operating time, less postoperative pain, reduced chest complications, a shorter postoperative hospital stay, and earlier return to normal daily activities than the conventional open repair.

Laparoscopic Management of Perforated Ulcers

This chapter describes laparoscopic repair of perforated ulcer including primary repair and Graham patch technique focusing on operating room set-up, instrumentation, operative steps, contraindications and post-operative care.

Laparoscopic repair of perforated gastroduodenal ulcer by running suture

The closure of perforated gastric ulcers with the Lahodny suture is safe and simple to perform and described a technique that does not require intra-corporal or extra-cor temporal knotting.



[Laparoscopic treatment of perforated peptic ulcer].

The laparoscopic treatment of perforated duodenal is a technically simple and effective procedure, intermediate between conventional surgical treatment and Taylor's method, and may have a real place in the treatment ofperforated peptic ulcer.

[Treatment of perforated peptic ulcer using the round ligament under celioscopy].

Preliminary results suggest that the celioendoscopic treatment of perforated peptic ulcers might be proposed whenever vagotomy does not seem to be absolutely necessary, especially in cases of acute ulcer occurring in younger subjects.

A randomized trial of nonoperative treatment for perforated peptic ulcer.

It is concluded that in patients with perforated peptic ulcer, an initial period of nonoperative treatment with careful observation may be safely allowed except in patients over 70 years old, and that the use of such an observation period can obviate the need for emergency surgery in more than 70 percent of patients.

Conservative treatment of 155 cases of perforated peptic ulcer.

During 23 years a total of 155 cases of verified perforated peptic ulcer were treated conservatively, according to the routine of the department, with a complication rate of 31%, and a mortality rate

Simple closure of perforated duodenal ulcer: A prospective evaluation of a conservative management policy

The results support continuation of the ‘wait and see’ policy following simple closure of perforated duodenal ulcer, even in patients with a history of chronic dyspepsia.

Perforated peptic ulcer.

The incidence in females and the elderly in this series was higher than reported elsewhere, and the risk of perforation increased with age, being greatest after 55; this was not due to an excess of chronic ulcers in older patients, indicating that ageing is an etiological factor.

Long-term results after omental patch repair in patients with perforated duodenal ulcers: a 5- to 10-year follow-up study.

Use of an omental patch is effective treatment for perforated duodenal ulcers and provides long-term benefit for patients whose perforations are associated with ulcerogenic medications.

Long-term results after omental patch repair in patients with perforated duodenal ulcers: a 5- to 10-year follow-up study.

Use of an omental patch is effective treatment for perforated duodenal ulcers and provides long-term benefit for patients whose perforations are associated with ulcerogenic medications.

Simple suture with or without proximal gastric vagotomy for perforated duodenal ulcer

PGV is a safe operation with a negligible morbidity rate and with a significant rate of effective control of ulcer disease, and depending on the general condition of the patient and on the surgeon's skill, it appears preferable to treat not only the acute perforation but also the ulcers disease by PGV.

Operative mortality after perforated peptic ulcer

The question that needs to be addressed is why some individuals with malignant disease have raised leucine flux or nitrogen turnover, and the hypothesis that ‘host’ immune responses to some tumours are responsible for systemic metabolic changes need to be explored.