Outcome of laparoscopic versus open repair of perforated peptic ulcers in low-risk patients

Abstract

Background Peptic ulcer perforation (PPU) represents the main indication for emergent surgical intervention for peptic ulcer disease. The study aimed to assess the efficacy and safety of laparoscopic repair (PPU) in comparison with open repair in low-risk patients. Methods A retrospective study was conducted in a tertiary medical institution that included 98 patients diagnosed with PPU in line with the inclusion criteria. An analysis was performed to compare patients who underwent laparoscopic surgery (LS) (n=31) and patients submitted to open surgery (OS) of PPU (n=67). Characterization of LS and OS was achieved in terms of patients’ demographics, Bœy’s score, PULP score, and intraoperative and postoperative data. Results The patient’s mean age in the LS and OS groups were 48.8 and 51.1 years, respectively. Most patients in both groups were men (87.1% and 86.5%, respectively). The mean time for resumption of oral intake after surgery was 2.93 ±1.06 (1–7) days in the laparoscopy group compared with 3.79±0.8 (2–7) days in the laparotomy group (P<0.0001). The average length of hospital stay was 5.77± 1.8 (4–13) days in the LS group and 7.22±1.6 (5–12) days in the OS group (P=0.0001). Early complications (<30 days) were found in 12 patients (12.2%); 3 (9.6%) in the LS group and 9 (13.4%) in the OS group (P=0.5). Conclusion Repair of PPU by laparoscopy is a better alternative to the open approach regarding reduction of postoperative hospital stay and fast return to daily activity with less postoperative ileus and wound complications.