OUTCOME OF GRAHAM PATCH OMENTOPEXY IN THE MANAGEMENT OF PERFORATED DUODENAL ULCER

MA KHAN; WY KHAN; MU KHAN; E HUSSAIN; S KHAN; SZ USMAN

doi:10.54112/bcsrj.v2024i1.1123

Authors

MA KHAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
WY KHAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
MU KHAN Department of Ophthalmology, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
E HUSSAIN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
S KHAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
SZ USMAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1123

Keywords:

Duodenal Perforated Ulcer, Peptic Ulcer, Complications, Graham’s Omentopexy

Abstract

Perforated duodenal ulcer remains a surgical emergency with significant morbidity and mortality. Graham’s patch omentopexy is a commonly performed procedure for its management. Evaluating the outcomes of this technique is crucial for improving patient care. Objective: To examine the outcomes of Graham’s patch omentopexy in managing perforated duodenal ulcers, focusing on postoperative complications. Methods: This study included 45 patients diagnosed with perforated duodenal ulcers who underwent Graham’s patch omentopexy from June 2023 to December 2023. The outcomes were assessed in terms of postoperative complications, including wound infection, wound dehiscence, pneumonia, bile leakage, abdominal abscess, and mortality. Results: The mean age of the patients was 46.49 ± 9.58 years. Postoperative complications included wound infection in 14 patients (31.3%), wound dehiscence in 13 patients (28.9%), pneumonia in 6 patients (13.3%), bile leakage in 5 patients (11.1%), abdominal abscess in 6 patients (13.3%), and mortality in 1 patient (2.2%). Conclusion: Graham’s patch omentopexy is an effective technique for managing perforated duodenal ulcers; however, complications such as wound infection, dehiscence, pneumonia, bile leakage, abdominal abscess, and mortality can occur. Further studies are needed to identify factors associated with these complications to optimize patient outcomes.

Downloads

Download data is not yet available.

References

Machado NO. Management of duodenal perforation post-endoscopic retrograde cholangiopancreatography. When and whom to operate and what factors determine the outcome? A review article. JOP Journal of the Pancreas. 2012;13(1):18-25.

Møller M, Adamsen S, Thomsen R, Møller A. Multicentre trial of a perioperative protocol to reduce mortality in patients with peptic ulcer perforation. Journal of British Surgery. 2011;98(6):802-10.

Lau JY, Sung J, Hill C, Henderson C, Howden CW, Metz DC. Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion. 2011;84(2):102-13.

Ansari D, Torén W, Lindberg S, Pyrhönen H-S, Andersson R. Diagnosis and management of duodenal perforations: a narrative review. Scandinavian journal of gastroenterology. 2019;54(8):939-44.

Lanas A, Chan FK. Peptic ulcer disease. The Lancet. 2017;390(10094):613-24.

Musbahi MA. BOMSS 2024 Congress Abstracts.

Khare AK, Patel KP, Chopra AK, Goyal P, Paliwal A, Baindur AJ, et al. Graham’s patch omentopexy versus modified Graham’s patch omentopexy in duodenal perforation–A comparative study. Asian Journal of Medical Sciences. 2024;15(8):156-61.

Xue DYB, Mohan R, Shelat VG. Perforated Peptic Ulcer. Textbook of Emergency General Surgery: Traumatic and Non-traumatic Surgical Emergencies. 2023:1067-84.

Satapathy MC, Dash D, Panda C. Modified Grahams′ omentopexy in acute perforation of first part of duodenum; A tertiary level experience in South India. Saudi Surgical Journal. 2013;1(2):33-6.

Cellan-Jones C. A rapid method of treatment in perforated duodenal ulcer. British medical journal. 1929;1(3571):1076.

Abouelazayem M, Jain R, Wilson MS, Martinino A, Balasubaramaniam V, Biffl W, et al. Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study. Surgical Endoscopy. 2024;38(8):4402-14.

Mohamedahmed AYY, Albendary M, Patel K, Ayeni AA, Zaman S, Zaman O, et al. Comparison of omental patch closure versus simple closure for laparoscopic repair of perforated peptic ulcer: a systematic review and meta-analysis. The American Surgeon™. 2023;89(5):2005-13.

Alkhuzaie J, Alaradi H. Presentation and Management of Perforated Duodenal Ulcer. Bahrain Medical Bulletin. 2018;40(4).

Gupta S, Kaushik R, Sharma R, Attri A. The management of large perforations of duodenal ulcers. BMC surgery. 2005;5:1-5.

Testini M, Portincasa P, Piccinni G, Lissidini G, Pellegrini F, Greco L. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World Journal of Gastroenterology. 2003;9(10):2338.

Walt R, Logan R, Katschinski B, Ashley J, Langman M. Rising frequency of ulcer perforation in elderly people in the United Kingdom. The Lancet. 1986;327(8479):489-92.

Hamby L, Zweng T, Strodel W. Perforated gastric and duodenal ulcer: an analysis of prognostic factors. The American surgeon. 1993;59(5):319-23; discussion 23.

Sedarat A. Clips for closure of full-thickness defects. Techniques in Gastrointestinal Endoscopy. 2015;17(3):129-35.

Abdallah HA, Saleem A-E-AA. Comparative study between Graham’s omentopexy and modified-Graham’s omentopexy in treatment of perforated duodenal ulcers. The Egyptian Journal of Surgery. 2018;37(4).