COMPARATIVE STUDY OF LAPAROSCOPIC AND OPEN REPAIR OF DUODENAL ULCER PERFORATION

Dr. RAMESH DHARMAVARAM; Dr .N.KRISHNA MOHAN; DR. B. ASHA DEEPTHI

Volume : V, Issue : V, May - 2015

COMPARATIVE STUDY OF LAPAROSCOPIC AND OPEN REPAIR OF DUODENAL ULCER PERFORATION

Dr. Ramesh Dharmavaram, Dr . N. Krishna Mohan, Dr. B. Asha Deepthi,

Abstract :

BACKGROUND: Peritonitis due to perforated duodenal ulcer is relatively common in our setup. Postoperative pain and morbidity remain the main concerns after conventional open approach of perforation repair. AIM& OBJECTIVES: The goal of this study is to compare the effectiveness and outcomes of laparoscopic and open methods of duodenal perforation repair in terms of Duration of surgery, Time to resume orals, Analgesic requirement, Hospital stay, Post–operative complications and Time to return to normal activity. STUDY DESIGN: prospective comparative study MATERIAL AND METHODS: Patients undergoing laparoscopic or open repair of duodenal ulcer perforation in Gandhi hospital from the period of August 2012 to August 2014 were studied prospectively .A total of 69 patients, 23 in the laparoscopy group and 46 in the open group were compared. Statistical methods: Student t test (two tailed, independent) has been used to find the significance of study parameters on continuous scale between two groups. Chi–square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between two or more groups. P–value< 0.05 is considered as significant. RESULTS: Time to resume normal diet, analgesic requirement, duration of hospital stay and time to return to normal activity and economic burden were significantly lower in the laparoscopy group along with best cosmetic results. Post–operative complications like wound infection and wound pain were significantly higher in the open group whereas there was no significant difference in post–operative fever, respiratory infections, prolonged ileus and intra–peritoneal collections. Conclusions: laparoscopic simple closure of perforated peptic ulcer disease is safe and may be the first and suitable method of treatment up to now.