Laparoscopic peptic perforation repair: our experience at rural tertiary care center

Abstract

Background: Peptic perforation is a life threatening complication of peptic ulcer disease requiring prompt surgical management. Omental patch repair with peritoneal lavage is the mainstay of treatment for perforated peptic ulcer at most of the centres. Laparoscopic repair has been described by various authors since 1990 in different part of world. In current study we have assessed the feasibility and safety of use of laparoscopy for this life threatening surgical emergency. The outcome were analyzed in terms of operating time, post-operative complications, medication, hospital stay, morbidity and mortality. Methods: This study was carried out in period of two years from January 2012 to December 2013. Patients were initially assessed in emergency department and then after resuscitation taken up for surgery. Patients with provisional diagnosis of perforated peptic ulcer were included in the study, meeting inclusion criteria. Results: Total 30 patients were studied out of total 38, who were operated in the study period. 26 males and 4 females, age ranged from 18-60 years, operative time was 55 to 110 minutes. In post-operative period the need for intravenous medication (analgesics and antibiotics) was less, early assumption of routine activity and early discharge. A very important factor noted that patient were psychologically so happy and convinced that they did not have big wound over abdomen and they can resume their routine activity as before. Conclusions: Laparoscopic repair of perforated peptic ulcer is safe and effective in experienced hands in most of the patients. It offers all advantages of laparotomy without compromising the safety and outcome.