Laparoscopic closure of perforated gastro-duodenal ulcer: 15 years' experience in our centre.

Abstract

IntroductionThe objective of the study is to share the results and development findings on the laparoscopic closure technique applied in our centre during a 15-year period (1998–2012).AimTo compare statistically the standard parameters (hospitalization, duration of operation) versus conventional surgery, and at the same time we compared mainly morbidity and mortality.Material and methodsDuring the period under review we operated on a total of 259 patients, 115 (44.4%) of them laparoscopically, and 144 (55.6%) of them conventionally. The sample was divided into two groups: patients with ASA physical status classification system 1–3, and patients with ASA 4–5.ResultsThe results favour laparoscopy within the group with ASA 1–3 in terms of several parameters, namely: duration of hospitalization – 7.7 days in the case of laparoscopic intervention, vs. 10.6 days for conventional surgery (p < 0.05); and duration of operation – 61 min vs. 85.1 min respectively (p < 0.05). Total morbidity was 27.5% in the case of patients with conventional surgery, vs. 10.9% with laparoscopic intervention (p < 0.05). The sample of patients with ASA 4–5 suffered a high mortality of 82.7%.ConclusionsLaparoscopic closure of perforated ulcer is a safe therapeutic method, as confirmed by the results of many other studies around the world, which in many aspects favour the laparoscopic technique.