Laparoscopic and open approach in perforated peptic ulcer.

BACKGROUND/AIMS: To improve the perioperative course and quality of life of the patients with perforated peptic ulcer, we investigated the conversion risk factors in laparoscopic simple closure and omental patch repair for perforated peptic ulcer.

METHODOLOGY: A total of 71 patients with a mean age of 46 years (rage, 17-81 years) was examined, and their clinical data was recorded and analyzed.

RESULTS: The postoperative durations of nasogastric tube insertion, ileus, analgesic requirement, resuming diet, and hospital stay were shorter in the patients with laparoscopic simple closure than in those with open simple closure and omental patch repair. Univariate regression analysis revealed that the age, American Society of Anesthesiologist classification, presence of concomitant disease, and length of free air or fluid collection shown in abdominal computerized tomography significantly correlated with the conversion of laparoscopic simple closure and omental patch repair to open simple closure and omental patch repair.

CONCLUSIONS: These conversion factors are useful to achieve appropriate surgical treatments for perforated peptic ulcer.