Comparative Study of Laparoscopic vs Open Surgery for Duodenal Ulcer Perforation

Usama  fazal; Abdullah  shah; Zeeshan  Alam; Hazrat Abu Bakar  Saddiqe; Abdul Basit  Khan; Javairia Riaz  Masood

doi:10.54112/bcsrj.v6i2.1590

Authors

Usama fazal Department of General Surgery, Saidu Group of Teaching Hospital, Swat, Pakistan
Abdullah shah Department of General Surgery, Lady Reading Hospital, Peshawar, Pakistan
Zeeshan Alam Department of General Surgery, Lady Reading Hospital, Peshawar, Pakistan
Hazrat Abu Bakar Saddiqe Department of General Surgery, Lady Reading Hospital, Peshawar, Pakistan
Abdul Basit Khan Department of General Surgery, Bacha Khan Medical College, Mardan, Pakistan
Javairia Riaz Masood Department of General Surgery, Saidu Group of Teaching Hospital, Swat, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i2.1590

Keywords:

Laparoscopic surgery, open surgery, perforated duodenal ulcer, postoperative complications, hospital stay, recovery time

Abstract

Perforated duodenal ulcers are a typical surgical emergency. While open surgery has long been the standard treatment, laparoscopic techniques are gaining popularity due to their minimally invasive nature and potential for improved postoperative outcomes. Objective: To compare the outcomes of laparoscopic versus open surgery in the management of perforated duodenal ulcers. Methods: This randomised comparative study included 64 patients diagnosed with perforated duodenal ulcers. Patients were randomly assigned into two groups: Group A (n = 32) underwent laparoscopic surgery, and Group B (n = 32) underwent open surgery. Postoperative outcomes were evaluated, including operative time, duration of hospital stay, time to resume normal activities, and postoperative complications. Statistical analysis was performed using standard methods, with significance set at p ≤ 0.05. Results: Laparoscopic surgery was associated with a significantly longer operative time compared to open surgery (102.38 ± 22.62 minutes vs. 66.53 ± 11.49 minutes, p < 0.001). However, patients in the laparoscopic group experienced a significantly shorter hospital stay (8.47 ± 1.11 days vs. 10.03 ± 2.67 days, p = 0.005) and returned to normal activities sooner (15.09 ± 3.14 days vs. 19.44 ± 3.10 days, p < 0.001). Additionally, the laparoscopic group reported fewer postoperative complications compared to the open surgery group. Conclusion: Laparoscopic surgery, despite a longer operative time, demonstrates superior postoperative outcomes in the management of perforated duodenal ulcers, including reduced hospital stay, fewer complications, and faster recovery. It may be considered a preferable alternative to open surgery in suitable patients.

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References

Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment, and prognosis. World J Surg. 2000;24(3):277-83.

Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Digest Surg. 2010;27(3):161-9.

Bhaskar D, Alishala D. Acute peritonitis: a clinical study. Int J Surg Sci. 2020;11:31.

Yadav D, Garg PK. Spectrum of perforation peritonitis in Delhi: 77 cases experience. Indian Journal of Surgery. 2013;75:133-7.

Kaundal V, Sharma V. A clinical profile of perforated duodenal ulcer. Hindu. 2019;58:99.

Grassi R, Romano S, Pinto A, Romano L. Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients. Eur J Radiol. 2004;50(1):30-6.

Weledji EP. An overview of gastroduodenal perforation. Frontiers in surgery. 2020;7:573901.

Thirupathaiah K, Jayapal L, Amaranathan A, Vijayakumar C, Goneppanavar M, Ramakrishnaiah VP. The association between Helicobacter pylori and perforated gastroduodenal ulcer. Cureus. 2020;12(3):e023

Salih BA. Helicobacter pylori infection in developing countries: the burden for how long?. Saudi J Gastroenterol. 2009;15(3):201-7.

Yeung KW, Chang MS, Hsiao CP, Huang JF. CT evaluation of gastrointestinal tract perforation. Clin Imag. 2004;28(5):329-33.

Zhou MW, Gu XD, Xiang JB, Chen ZY. Clinical safety and outcomes of laparoscopic surgery versus open surgery for palliative resection of primary tumors in patients with stage IV colorectal cancer: a meta-analysis. Surg Endosc. 2016;30:1902-10.

Kiblawi R, Zoeller C, Zanini A, Kuebler JF, Dingemann C, Ure B, et al. Laparoscopic versus open pediatric surgery: three decades of comparative studies. Eur J Pediatr Surg. 2022;32(01):009-25.

Zhang Y, Liu C, Nistala KR, Chong CS. Open versus laparoscopic Hartmann’s procedure: a systematic review and meta-analysis. Int J Colorect Dis. 2022;37(12):2421-30.

Lau WY, Leung KL, Kwong KH, Davey IC, Robertson C, Dawson JJ, et al. A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique. Ann Surg. 1996;224(2):131-8.

Deshmukh SN, Parikh HP. Open versus laparoscopic repair of perforated duodenal ulcer: a comparative study. Int Surg J. 2020;7:1004-1008.

Lunevicius R, Morkevicius M. Comparison of laparoscopic versus open repair for perforated duodenal ulcers. Surg Endosc. 2005;19:1565-71.

Pelloni M, Afonso-Luís N, Marchena-Gomez J, Piñero-González L, Ortíz-López D, et al. Comparative study of postoperative complications after open and laparoscopic surgery of the perforated peptic ulcer: Advantages of the laparoscopic approach. Asian J Surg. 2021;45(4):1007-1013.