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Laparoscopic versus open repair of perforated peptic ulcer: A retrospective cohort study
Author(s) -
Smith Rohan Stuart,
Sundaramurthy Senthilkumar Rajavel,
Croagh Daniel
Publication year - 2019
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12600
Subject(s) - medicine , retrospective cohort study , surgery , incidence (geometry) , cohort , laparoscopy , complication , cohort study , peptic , peptic ulcer , general surgery , physics , optics
Abstract Introduction Perforated peptic ulcer disease (PPU) is a condition subject to wide geographical variations in incidence. It remains a significant cause of morbidity and mortality, even in the era of Helicobacter pylori eradication and proton‐pump inhibitor therapy. There is no clear consensus on whether laparoscopic or open approaches are superior, and with most studies in this area originating from Europe and Asia, Australian data addressing this issue are lacking. Methods This retrospective cohort study included all patients who underwent surgery for PPU within a hospital network in Australia. Baseline variables and primary outcomes, including length of hospital stay, chest and abdominal complications, and mortality, were recorded. Secondary outcomes, including reasons for conversion, were also considered. Results In total, 109 patients underwent operations for PPU between January 2011 and December 2015. There were no significant differences with regard to baseline comorbidities. There were no statistically significant differences in terms of median length of hospital stay or rates of chest and abdominal complications, but the operative time was 28.5 min longer ( P = <0.001) in the laparoscopic group than in the open group. Conclusion Open operations were faster to perform than laparoscopic operations for repair of PPU. Despite increased experience treating many surgical diseases laparoscopically, this study did not find it to be superior in terms of length of hospital stay or complication rates.