Comparison between laparoscopic and conventional omental patch repair for perforated duodenal ulcer.

BACKGROUND: The aim of the study is to evaluate the safety and efficacy of laparoscopic omental patch repair.

METHOD: This is a retrospective review of 53 consecutive patients with omental patch repair for perforated duodenal ulcer; 38 underwent conventional open approach and 15 underwent laparoscopic patch repair. The only selection criterion was availability of expertise for laparoscopic repair on the day of admission. By chance, the open group had poorer ASA scores. There were four deaths and five postoperative complications in the open group.

RESULTS: Laparoscopic repair was successful in 14 cases with one postoperative complication. Operative time was longer in the laparoscopic group (80 vs 65 min in open group, p = 0.02). Patients required less postoperative analgesics in the laparoscopic group (median amount of pethidine was 75 mg vs 175 mg in the open group, p = 0.03). There was no statistically significant difference in terms of hospital stay and return to normal activities between the two procedures. Follow-up Visick scores were comparable in both groups.

CONCLUSIONS: Laparoscopic omental patch repair offers a safe alternative to the conventional method and causes less postoperative pain.