Purpose: As the diagnostic and treatment modalities for the peptic ulcer disease have evolved, the number of elective operations for this disease has decreased, however that of emergency operations has increased in recent two decades. Perforation, obstruction, and bleeding are the indications for the emergency operation. In this report, we present our experience with laparoscopic primary closure for perforated peptic ulcer and laparoscopic truncal vagotomy with gastrojejunostomy for obstruction. Methods: From March 1998 to February 2004 nineteen patients who underwent laparoscopic primary closure for perforated peptic ulcer and two patients who underwent laparoscopic truncal vagotomy with gastrojejunostomy for obstruction at our institution were involved in this study. Results: Mean operation time for laparoscopic primary repair was 101 minutes and mean hospital stay, 6.2 days. Liquid or semi solid diet resumed at 4.1 mean postoperative stay. Mean operation time for laparoscopic truncal vagotomy with gastrojejunostomy was 225 minutes and the mean hospital day, 7.5 days. Liquid or semi solid diet resumed at 4.5 mean postoperative days. There was no conversion to laparotomy. No anastomotic leakage, stricture and no mortality occurred in both groups. Conclusion: Laparoscopic procedure for surgical treatment in complicated peptic ulcer, mainly perforation or obstruction, seems to be safe and effective. Minimally invasive surgery offers additional advantage for high-risk and elderly patients.

Keywords: Peptic ulcer disease, Laparoscopy, Primary closure, Truncal vagotomy, Gastrojejunostomy