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KMID : 0978820080110020077
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 2 p.77 ~ p.80
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A Clinical Review of Laparoscopic Primary Closure for Treating Peptic Ulcer Introduction
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Kim Ra-Mi
Suh Byung-Sun
Kim Ki-Ho
Park Jin-Soo
Kim Sang-Wook
Shin Dong-Woo
Kim Il-Dong
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Abstract
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Purpose: Patients with peptic ulcer are operated due to ulcer perforation in most cases. Laparoscopy is on the increase for treating such cases as these because a least invasive operative method is preferred to an open one. We studied the feasibility and safety of performing primary closure with laparoscopy for peptic ulcer perforation.
Methods: The study subjects were 19 patients who had been operated on for primary closure with laparoscopy at our hospital from May 2005 to May 2007. We studied the patients and their clinical characteristics, and we analyzed the operative time, the number of hospital days, ulcer recurrence, complications, the pain scale and the relation with H. pylori infection.
Results: Among the 19 patients, two of them were converted to open procedures due to severe cicatrical changes of the perforated sites. 12 patients had duodenal ulcer perforation and 5 had gastric ulcer perforation. 12 patients had acute ulcer and 4 had chronic ulcer. There were 14 smokers. The mean hospital stay was 8.5 days, and the mean operative time was 137.3 min. The mean time to removal of the drainage tube was 5.9 days, and they started feeding 3.6 days after operation on average. Analgesics were used 1.6 times on average and 8 patients didn’t want additional analgesics. Gastrofiberscope was performed and 8 patients had H. pylori. So, 7 were treated by antibacterial therapy. Three of them didn’t have H. pylori on their follow-up endoscopy, and 6 other patients weren’t examined by follow-up endoscopy. Some patients had little appetite and heartburn, but none of the patients were re-operated on for recurrent ulcer or perforation.
Conclusion: Primary closure with laparoscopy for treating peptic ulcer perforation is a safe, reliable and least invasive method of operation.
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KEYWORD
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Laparoscopy, Ulcer perforation, Primary repair
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