THE ROLE OF NASOGASTRIC TUBE AFTER LAPAROSCOPIC REPAIR OF SMALL PERFORATION OF DUODENAL ULCERS IN LOW RISK PATIENTS

Abstract

Background: The aim of this study was to evaluate the role of nasogastric tube after laparoscopic repair of small peforation of duodenal ulcers in low risk patients. Methods: A retrospective study on 69 consecutive perforated duodenal ulcer patients with size of perforation of less than 5 mm, ASA score of less than 4, Boey score of less than 2, treated with laparoscopic repair at Hue University of Medicine and Pharmacy Hospital from January 2012 to June 2018. Patients were divided into two groups: group 1 with postoperative nasogastric tube and group 2 without postoperative nasogastric tube because patients were uncooperative and removed the nasogastric tube themselves. Results: The mean age was 47.8 ± 14.7 years. Male/female ratio was 22. The mean of duration from symptom onset until surgery was 7.5 ± 5.5 hours. 60 patients (87.0%) had a Boey score of 0 and nine patients (13.0%) had a Boey score of 1. The mean of size of perforation was 3.5 ± 1.0 mm. All of perforations were on the anterior duodenal wall. The patients in the group 2 had a significantly shorter interval between surgery and passage of first flatus than in group 1 (1.8 ± 0.5 days vs 2.6 ± 0.7 days (p = 0.042)), had a significantly shorter postoperative hospital stay than in group 1 (4.5 ± 0.6 days vs 5.8 ± 0.8 days (p = 0.026)). There was no significant difference between group 1 and group 2 in the duration of analgesic use (2.3 ± 0.5 days vs 2.8 ± 0.8 days, p = 0.097). There was no morbidity or mortality in two groups. Conclusions: The patients without postoperative nasogastric tube had a significantly shorter interval between surgery and passage of first flatus and postoperative hospital stay. The use of postoperative nasogastric tube in small perforations of duodenal ulcers in low risk patients seems to be unnecessary. Key words: Perforated duodenal ulcer, laparoscopic repair, laparoscopic surgery, nasogastric tube