Surgical tactics for perforative ulcers stomach and duodenum

Omarov M., Magomedov M., Magomedov M.

Target. Evaluation of the effectiveness of surgical treatment of perforated gastric and duodenal ulcers in a comparative aspect using various methods. Materials and methods. Clinical studies of the results of treatment of 117 patients with perforated gastric and duodenal ulcers were carried out in a comparative aspect using laparoscopic and open methods of surgical treatment. Among the operated were 98 (81.7%) men and 22 (18.3%) women, aged from 21 to 65 years. Indications for laparoscopic suturing were established in 56 (46.7%) patients and for open surgery - in 61 (50.8%) patients. The study included a patient with a perforated ulcer within 2 cm. Outcome indicators were determined according to length of stay, postoperative complications and mortality. Results. All 117 patients met the pre-established study inclusion criteria. The mean surgery time was slightly longer in the laparoscopy group compared to the open surgery group (74.01 and 56.17 minutes, respectively). The average need for postoperative analgesia, mobilization time and hospital stay were significantly shorter after laparoscopy than after open surgery (1.21 days, 9.32 hours and 3.12 days; versus 3.83 days, 16.20 hours and 4 , 85 days, respectively). Postoperative complications were observed in 6 (10.7%) patients in the laparoscopy group and in 24 (39.3%) patients in the open surgery group. Conclusions. Laparoscopic ulcer suturing is a safe approach and more effective than open surgery in terms of the need for postoperative analgesia, mobilization, length of hospital stay, and incidence of postoperative respiratory and wound complications.

Keywords:laparoscopy, perforation, perforated duodenal ulcer, suturing.