Original Article

J Minim Invasive Surg 2008; 11(2): 77-80

Published online December 15, 2008

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

소화성 궤양 천공의 복강경 단순 봉합술에 대한 임상적 고찰

김라미ㆍ서병선ㆍ김기호ㆍ박진수ㆍ김상욱ㆍ신동우ㆍ김일동

분당제생병원 외과

A Clinical Review of Laparoscopic Primary Closure for Treating Peptic Ulcer Introduction

Ra Mi Kim, M.D., Byung Sun Suh, M.D., Ki Ho Kim, M.D., Jin Soo Park, M.D., Sang Wook Kim, M.D., Dong Woo Shin, M.D., Il Dong Kim, M.D.

Department of Surgery, Pundang Jesaeng General Hospital, Seongnam, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Patients with peptic ulcer are operated due to ulcer perforation in most cases. Laparoscopy is on the increase for treating such cases as these because a least invasive operative method is preferred to an open one. We studied the feasibility and safety of performing primary closure with laparoscopy for peptic ulcer perforation. Methods: The study subjects were 19 patients who had been operated on for primary closure with laparoscopy at our hospital from May 2005 to May 2007. We studied the patients and their clinical characteristics, and we analyzed the operative time, the number of hospital days, ulcer recurrence, complications, the pain scale and the relation with H. pylori infection. Results: Among the 19 patients, two of them were converted to open procedures due to severe cicatrical changes of the perforated sites. 12 patients had duodenal ulcer perforation and 5 had gastric ulcer perforation. 12 patients had acute ulcer and 4 had chronic ulcer. There were 14 smokers. The mean hospital stay was 8.5 days, and the mean operative time was 137.3 min. The mean time to removal of the drainage tube was 5.9 days, and they started feeding 3.6 days after operation on average. Analgesics were used 1.6 times on average and 8 patients didn't want additional analgesics. Gastrofiberscope was performed and 8 patients had H. pylori. So, 7 were treated by antibacterial therapy. Three of them didn't have H. pylori on their follow-up endoscopy, and 6 other patients weren't examined by follow-up endoscopy. Some patients had little appetite and heartburn, but none of the patients were re-operated on for recurrent ulcer or perforation. Conclusion: Primary closure with laparoscopy for treating peptic ulcer perforation is a safe, reliable and least invasive method of operation.

Keywords Laparoscopy, Ulcer perforation, Primary repair

Article

Original Article

J Minim Invasive Surg 2008; 11(2): 77-80

Published online December 15, 2008

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

소화성 궤양 천공의 복강경 단순 봉합술에 대한 임상적 고찰

김라미ㆍ서병선ㆍ김기호ㆍ박진수ㆍ김상욱ㆍ신동우ㆍ김일동

분당제생병원 외과

A Clinical Review of Laparoscopic Primary Closure for Treating Peptic Ulcer Introduction

Ra Mi Kim, M.D., Byung Sun Suh, M.D., Ki Ho Kim, M.D., Jin Soo Park, M.D., Sang Wook Kim, M.D., Dong Woo Shin, M.D., Il Dong Kim, M.D.

Department of Surgery, Pundang Jesaeng General Hospital, Seongnam, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Patients with peptic ulcer are operated due to ulcer perforation in most cases. Laparoscopy is on the increase for treating such cases as these because a least invasive operative method is preferred to an open one. We studied the feasibility and safety of performing primary closure with laparoscopy for peptic ulcer perforation. Methods: The study subjects were 19 patients who had been operated on for primary closure with laparoscopy at our hospital from May 2005 to May 2007. We studied the patients and their clinical characteristics, and we analyzed the operative time, the number of hospital days, ulcer recurrence, complications, the pain scale and the relation with H. pylori infection. Results: Among the 19 patients, two of them were converted to open procedures due to severe cicatrical changes of the perforated sites. 12 patients had duodenal ulcer perforation and 5 had gastric ulcer perforation. 12 patients had acute ulcer and 4 had chronic ulcer. There were 14 smokers. The mean hospital stay was 8.5 days, and the mean operative time was 137.3 min. The mean time to removal of the drainage tube was 5.9 days, and they started feeding 3.6 days after operation on average. Analgesics were used 1.6 times on average and 8 patients didn't want additional analgesics. Gastrofiberscope was performed and 8 patients had H. pylori. So, 7 were treated by antibacterial therapy. Three of them didn't have H. pylori on their follow-up endoscopy, and 6 other patients weren't examined by follow-up endoscopy. Some patients had little appetite and heartburn, but none of the patients were re-operated on for recurrent ulcer or perforation. Conclusion: Primary closure with laparoscopy for treating peptic ulcer perforation is a safe, reliable and least invasive method of operation.

Keywords: Laparoscopy, Ulcer perforation, Primary repair

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