Minilaprotomy Approach to Perforated Duodenal Ulcer

Background and Purpose: Although the technical feasibility of laparoscopic approach to perforated duodenal ulcer is well established, this procedure has not been widely performed because of several limitations. This retrospective study was performed to clarify the feasibility, safety, and minimal invasiveness of a minilaparotomy for perforated duodenal ulcer. Patients and Methods: We retrospectively analyzed data on40patients with perforated duodenal ulcer, who were attempted to undergo simple closure and/or omentopexy via minilaparotomy (skin incision, <7cm) between 2005.4 and 2009.7. Results: Patient ages ranged from 20 to85 years (median, 55 years). The male:female ratio was 27:13. The boy mass index was 15.1-29.0 (median, 20.1) kg/m2. The interval from onset to surgery was 2-72 (median, 9) hrs. The preoperative intra-abdominal fluid calculated according to themethod byOhawa et al. and the intraoperativelly suctioned fluid volume were 100-3400 (median, 660) mL and 5-2500 (median, 350) mL, respectively. The Manheim peritoneal index was 0-26 (median, 12). Minilaparotomy was successful in36 patients (90%). Duration of surgery was 30-165 (median, 60) min. Postoperative complications included intraabdominal abscess in two, wound infection in 4. There was no postoperative mortality. Postoperative analgesic use (pentazocin15 mg, im) was 0-6 (median, 1). Postoperative hospital stay was 6-26 (median,12) days.
Conclusions: These findings suggest that minilaparotomy approach to perforated duodenal ulcer is feasible, safe, and minimally invasive and seems to be an alternative to laparoscopic approach in selected patients with perforated duodenal ulcer.

Session: Podium Presentation

Program Number: S048