MID-TERM OUTCOME OF PERFORATED DUODENAL ULCER REPAIR USING SINGLE-PORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 57-62
Author(s):  
Huu Tri Nguyen ◽  
Loc Le
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Duodenal Wall ◽  
Perforated Duodenal Ulcer ◽  
Term Outcome ◽  
Ulcer Perforation ◽  
Port Site Hernia ◽  
Duodenal Ulcer Perforation

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate mid-term outcome of perforated duodenal ulcer repair using SPLS. Methods: A prospective study on 72 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue University Hospital and Hue Central Hospital from January 2012 to Mars 2016. Results: The mean age was 48.8 ± 14.0 (17 - 79) years. Male/female ratio was 17.0. Four patients (5.6%) with history of abdominal surgery were successfully treated by pure SPLS. Patients were classified as ASA 1, ASA 2 and ASA 3 in 86.1%, 12.5%, and 1.4% of cases, respectively. Using Boey scoring system, there were 86.1% and 12.5% of cases classified as Boey 0 and Boey 1 while there were no Boey 2 and 3 cases. The average size of perforation was 4.1 ± 2.6 (1.5-22) mm. The perforation was situated on the anterior duodenal wall in 98.6% of cases and on the posterior duodenal wall in 1.4% of cases. There was one case (1.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (1.4%) in which the perforation was situated on the posterior duodenal wall. Average length of hospital stay was 5.7 ± 1.2 (4-12) days. Post-operative complications rate was 2.8%. There was no leakage from the repair site, no port-site hernia and no post-operative mortality. At 2-month follow-up visit, patients were classified as Visick 1 in 95.1% of cases and Visick 2 in 4.9% of cases and the duodenal ulcer was completely healed on gastroduodenoscopy in 86.7% of cases. At 12-month follow-up, patients were classified as Visick 1 in 93.5% of cases and Visick 2 in 4.3% of cases. There was one case (2.2%)diagnosed with recurrent duodenal ulcer perforation at 5 months after the repair of the first perforation. On gastroduodenoscopy, recurrent duodenal ulcer was seen in 8.9% of cases. Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Conversion rate was 1.4%. Recurrent duodenal ulcer rate was 8,9% and recurrent duodenal ulcer perforation rate was 2.2% after 12-month follow-up. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

scholarly journals Relationship of Various Prognostic Factors with Outcome of Treatment of Chronic Duodenal Ulcer Perforation Patients

2014 ◽  
Vol 13 (2) ◽  
pp. 32-35
Author(s):  
Sakhawat Mahmud Khan ◽  
Meer Mahbubul Alam ◽  
Shahin Akhter ◽  
Didarul Alam
Keyword(s):  
Duodenal Ulcer ◽  
Prognostic Factors ◽  
Peritoneal Fluid ◽  
Ulcer Patient ◽  
Perforated Duodenal Ulcer ◽  
College Hospital ◽  
Major Health Problem ◽  
Ulcer Perforation ◽  
Chronic Duodenal Ulcer ◽  
Duodenal Ulcer Perforation

Background: In acute abdominal conditions, chronic duodenal ulcer  perforation is a very common surgical emergency that overwhelm the surgical ward throughout the year. Especially in the tropics and more in our country, peptic ulcer disease causes a major health problem. Objectives: To assess the usefulness of the prognostic factors in terms of morbidity and mortality in the treatment of perforated duodenal ulcer patient. Methods: This was a prospective study during the period from January 2003 to December 2003 in M.A.G. Osmani Medical College Hospital, Sylhet. The study included 100 cases of perforated chronic duodenal ulcer. Patients were randomly collected from all surgical units of SOMCH, Sylhet. Operation was done by simple closure with omental graft in all cases. Data analyzed by appropriate statistical method (Mean, SD & l2 test). Results: Highly significant relationship was found between increased age (>50 years) of patients with perforated duodenal ulcer and mortality (p<0.001). Lethality rate was higher in patients operated after 24 hours of onset of symptom in relation to patients operated within 24 hours of onset of symptom, (p<0.05). Different postoperative complications were prevalent in patients operated after 24 hours of onset of symptom, on the other hand complication rate was low in patients operated within 24 hours (p<0.001). There was also longer hospital stay in lately operated patients (more above median) than patients operated within 24 hrs (p<0.001). Mortality was higher in cases of purulent peritoneal fluid, where as it was nil in case of billous and serosanguinous fluid (p<0.001). More complications were developed in patients with purulent peritoneal fluid in comparison to billous and serosanguinous nature (p<0.001). There was more mortality in patients with preoperative shock in comparison with no features of shock (p<0.001). More complications were noted in patients with preoperative shock than in patients with no features of shock (p<0.01). Conclusion: Delayed operation, preoperative shock, more age and gross peritoneal sepsis bear a direct relationship with outcome of treatment chronic duodenal ulcer perforation patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21060

scholarly journals A CASE OF DUODENAL ULCER PERFORATION IN A 10-YEAR-OLD CHILD TREATED BY LAPAROSCOPIC SURGERY

2011 ◽  
Vol 72 (10) ◽  
pp. 2545-2549
Author(s):  
Tadayoshi OTSUKI ◽  
Atsushi IIDA ◽  
Yasuo HIRONO ◽  
Takanori GOI ◽  
Kanji KATAYAMA ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Ulcer Perforation ◽  
Duodenal Ulcer Perforation

scholarly journals A CLINICAL PROFILE OF PERFORATED DUODENAL ULCER

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Vishal Kaundal ◽  
Dr. Vikrant Sharma
Keyword(s):  
Duodenal Ulcer ◽  
Clinical Signs ◽  
Muscularis Propria ◽  
Signs And Symptoms ◽  
Clinical Profile ◽  
Perforated Duodenal Ulcer ◽  
Ulcer Perforation ◽  
Surgery Patient ◽  
Number Of Patients ◽  
Duodenal Ulcer Perforation

Background: Duodenal ulcer is a common condition characterized by the presence of a well- demarcated break in the mucosa that may extend into the muscularis propria of the duodenum. Methods: This prospective observational study was conducted in the Department of Surgery, Dr. Rajendra Prasad Government Medical College Kangra at Tanda, consisting of patients hospitalised   in department of surgery. Patient data was collected from all patients showing clinical signs and symptoms of perforated duodenal ulcer, attending Dr. RPGMC TANDA during 1 year period after ethical clearance of study. Results: The mean age of patients was 43 years with maximum number of patients were of age group between 19-45 years. Ninety two percent of patients were male and 8% were female. Sixty two percent of patients with duodenal ulcer perforation belong to low socioecnomic strata. Ten percent of patients  presented within 24 hours after onset of symptoms. Ten percent of patients out of 90 % which presented after 24 hours were in shock. Conclusion: Perforation of duodenal ulcer remains a frequent clinical problem in our environment predominantly affecting 19-45 years group labourer males known to suffer from duodenal ulcer. Keywords: Duodenal Ulcer, Perforation, Clinical Profile

Study of factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation

2021 ◽  
Vol 19 (2) ◽  
pp. 35-39
Author(s):  
Pradeep Chandra Sharma ◽  
Keyword(s):  
Duodenal Ulcer ◽  
Previous History ◽  
Common Factors ◽  
Duodenal Perforation ◽  
High Morbidity ◽  
Delayed Presentation ◽  
Mortality And Morbidity ◽  
Factors Affecting ◽  
Ulcer Perforation ◽  
Duodenal Ulcer Perforation

Background: Peptic ulcer disease in the general population had lifetime prevalence of 5-10% with incidence of 0.1–0.3% per year. Despite the tremendous improvement in preventive therapies, the rate of complication of this disease is still high and is burdened by high morbidity and mortality. In present study, we aimed to study factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation at our tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study conducted in patients admitted, diagnosed with duodenal ulcer perforation and surgically treated at our hospital. Results: In present study period total 56 patients were studied. All were male, most common age group was 51-60 years (37.5%) followed by 41-50 years (23.21%). Duration from onset of symptoms to admission was >24 hours (30.36%) in most of patients followed by 12-24 hours (28.57%). Most commons symptoms were pain in abdomen (100%), vomiting (100%). Anaemia (37.5%), LRTI and Pulmonary complications (19.64%), Diabetes mellitus (12.5%) and Hypertension (10.71%) were common comorbidities noted. Associated risk factors were previous history of PUD (41.07%), Alcohol use (64.29%), Cigarette smoking (51.79%) and Use of NSAIDs (12.5%). Presence of free gas under diaphragm was noted in 83.93% patients. Intraoperatively duodenal perforation diameter was 1–5 mm (60.71%) in most of patients followed by 6–10 mm (23.21%). Only 1 patient had duodenal perforation diameter was > 20mm. Common postoperative complications were wound infection (37.5%) and pulmonary infection (21.43%). In present study mortality within 1 month was noted in 13 patients (23.21%). Most common factors related to mortality were delayed presentation > 24 hours (61.54%), age > 60 years (46.15%), diabetes mellites (38.46%), Size of perforation > 1 cm (38.46%) and septicaemic shock (23.08%). Conclusion: Delayed presentation > 24 hours, age > 60 years size of perforation > 1 cm were common factors related to mortality in duodenal ulcer perforation patients.

Sign in / Sign up

Export Citation Format

Share Document