The Application of Laparoscopic Techniques in Treating Perforated Duodenal Ulcers, With an Emphasis on Efficacy, Safety, and Postoperative Results

Authors

  • Dr. Ali Hamel Mohaisen M.B.Ch.B., F.I.C.M.S. \ (General Surgeon) Iraqi Ministry of Health, Babylon Health Directorate, Gastroenterology Center, Babylon, Iraq
  • Dr. Zaydoon Abdulameer Hamza Al-Jebur M.B.Ch.B., F.I.C.M.S. \ (General Surgeon) Iraqi Ministry of Health, Babylon Health Directorate, Al-Imam Al-Sadiq Teaching Hospital, Babylon, Iraq
  • Dr. Akram Hadi Hamza M.B.Ch.B., C.A.B.S. \ (General Surgery), F.I.C.M.S. \ (Gastrodigestive Surgery) Iraqi Ministry of Health, Babylon Health Directorate, Gastroenterology Center, Babylon, Iraq

Keywords:

Perforated Duodenal Ulcers, Laparoscopic Technique, Post-operative Complications, SF-36 Questionnaire

Abstract

Background:

Perforation is a pries that develops in 4—15% of cases of duodenal ulcers, usually on the anterior aspect of the duodenal bulb.

Aim:

The present study is designed to analyze the role of laparoscopic procedures in the treatment of patients with perforated duodenal ulcers. Additionally, it is designed to assess the patient's general health and quality of life post-laparoscopy.

Methods:

This cross-sectional study was designed on 70 patients with perforated duodenal ulcers aged 32–48 years. All patients underwent endoscopic treatment at different hospitals in Iraq during the follow-up period, which began in April 2023 and lasted until April 2024. Demographic characteristics and intra- and postoperative outcomes, including time spent, mortality, complications, satisfaction, and pain, were recorded. Postoperative quality of life was assessed using the SF-36 questionnaire.

Results:

Our study enrolled the surgical data of 70 patients. Males got 80%, obesity with 50%, smokers included 42.86%, alcohol consumers have 12.86%, common symptoms and causes were severe abdominal pain with 72.86%, and pylori infection was 67.14%. According to laparoscopic procedure outcomes, operation time was 116.80 ± 14.95 minutes; pneumoperitoneum pressure was 12.55 ± 2.19 mmHg; length of hospital stays < 5 days have 94.29%, only one case had dead; time to the first bowel movement was 47.81 ± 9.02 hours, excellent satisfied with 77.14%, and post-operative complications had 11.43%, where abdominal abscess, pneumonia, and bowel obstruction had 2 cases for each factor. In the evaluation of the SF-36 questionnaire, we found physical functioning (86.14 ± 6.02) and psychological functioning (84.11 ± 2.89).

Conclusion:

Laparoscopy for perforated duodenal ulcers is safe and effective, decreasing complications and improvement of general health and quality of life.

References

Casali JJ, Franzon O, Kruel NF, Neves BD. Epidemiological analysis and use of rapid urease test in patients with perforated peptic ulcers. Rev Col Bras Cir 2012;39:93—8.

Zittel TT, Jehle EC, Becker HD. Surgical management of peptic ulcer disease today — an indication, technique, and outcome. Langenbecks Arch Surg 2000;385:84—96.

Sivri B. Trends in peptic ulcer pharmacotherapy. Fundam Clin Pharmacol 2004;18:23—31.

Lau H. Laparoscopic repair of perforated peptic ulcer: a meta-analysis. Surg Endosc 2004;18:1013—21.

Sanabria A, Villegas MI, Morales Uribe CH. Laparoscopic repair for perforated peptic ulcer disease. Cochrane Database Syst Rev 2013;2:CD004778.

Lee FY, Leung KL, Lai BS, Ng SS, Dexter S, Lau WY. Predicting mortality and morbidity of patients operated on for perforated peptic ulcers. Arch Surg 2001;136:90—4.

Lohsiriwat V, Prapasrivorakul S, Lohsiriwat D. Perforated peptic ulcer: clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. World J Surg 2009;33: 80—5.

Bertleff MJ, Lange JF. Laparoscopic correction of perforated peptic ulcer: first choice? A review of the literature. Surg Endosc 2010;24:1231—9.

Mouly C, Chati R, Scotté M, Regimbeau JM. Prise en charge de l’ulcère gastroduodénal perforé : revue de littérature. J Chir Visc 2013;150:333—40.

Dupont H, Bourichon A, Paugam-Burtz C, Mantz J, Desmonts JM. Can yeast isolation in peritoneal fluid be predicted in intensive care unit patients with peritonitis? Crit Care Med 2003;31:752—7.

Turner Jr WW, Thompson Jr WM, Thal ER. Perforated gastric ulcers. A plea for management by simple closures. Arch Surg 1988;123:960—4.

Søreide K, Thorsen K, Søreide JA. Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg 2014;101:e51—64.

Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010;27:161—9.

Gonenc M, Dural AC, Celik F, et al. Enhanced post-operative recovery pathways in emergency surgery: a randomised controlled clinical trial. Am J Surg 2014;207:807—14.

Zimmermann M, Wellnitz T, Laubert T, et al. Gastric and duodenal perforations: what is the role of laparoscopic surgery? Zentralbl Chir. 2014;139:72–8.

Thorsen K, Soreide J.A, Kvaloy JT, et al. Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality. World J Gastroenterol. 2013;19:347–54.

Sarosi GA, Jaiswal KR, Nwariaku FE, et al. Surgical therapy of peptic ulcers in the 21st century: more common than you think. Am J Surg. 2005;190:775–9.

Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg. 2010;27:161–9.

Siu WT, Leong HT, Li MK. Single stitch laparoscopic omental patch repair of perforated peptic ulcer. J R Coll Surg Edinb. 1997;42:2–4.

Kashiwagi H. Ulcer and gastritis. Endoscopy. 2007;39:101–5.

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

Thorsen K, Glomsaker T.B, von Meer A, et al. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. J Gastrointest Surg. 2011;15:1329–35.

Imhof M, Epstein S, Ohmann C, et al. Duration of survival after peptic ulcer perforation. World J Surg. 2008;32:408–12.

Bonin EA, Moran E, Gostout CJ, et al. Natural orifice transluminal endoscopic surgery for patients with perforated peptic ulcer. Surg Endosc. 2012;26:1534–8.

Guadagni S, Cengeli I, Galatioto C, et al. Laparoscopic repair of perforated peptic ulcer: single-center results. Surg Endosc. 2014;28:2302–8.

Mouly C, Chati R, Scotté M, et al. Therapeutic management of perforated gastro-duodenal ulcer: literature review. J Visc Surg. 2013;150:333–40.

Aljohari H, Althani H, Elmabrok G, et al. Outcome of laparoscopic repair of perforated duodenal ulcers. Singapore Med J. 2013;54:216–9.

Palanivelu C, Jani K, Senthilnathan P. Laparoscopic management of duodenal ulcer perforation: is it advantageous? Indian J Gastroenterol. 2007;26:64–6.

Kim JH, Chin HM, Bae YJ, et al. Risk factors associated with conversion of laparoscopic simple closure in perforated duodenal ulcer. Int J Surg. 2015;15:40–4.

Søreide K, Thorsen K, Søreide JA. Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg. 2014;101:51–64.

Byrge N, Barton RG, Enniss TM, et al. Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis. Am J Surg. 2013;206:957–63.

Downloads

Published

2025-03-29

How to Cite

Mohaisen, D. A. H., Al-Jebur, D. Z. A. H., & Hamza, D. A. H. (2025). The Application of Laparoscopic Techniques in Treating Perforated Duodenal Ulcers, With an Emphasis on Efficacy, Safety, and Postoperative Results. International Journal of Alternative and Contemporary Therapy, 3(3), 62–69. Retrieved from https://medicaljournals.eu/index.php/IJACT/article/view/1666

Similar Articles

<< < 1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.