comparing the clinical consequences of perforated of peptic ulcer between open and laparoscopic surgery

Abstract

Peptic ulcer disease (PUD) includes gastric ulcer (GU) and duodenal ulcer (DU). The rate of hospitalization and mortality due to bleeding and perforation of PUD has increased in the elderly, which is probably due to the increased use of ASA and NSAID in them. The three most important complications of PUD are: bleeding, perforation, and obstruction. Patients with perforation of PPUD come to surgery as an acute abdomen and are candidates for surgery in most cases. Open surgery has been used as a routine method, which has been considered and investigated according to the progress of laparoscopic surgery. Methods: In this study, patients diagnosed with acute abdominal surgery referred to the emergency department of Imam Reza Hospital in Tabriz. 32 patients were divided into the laparotomy group and 20 patients were divided into the laparoscopy group. After reviving the patients and recording the pre-operative tests, the patients underwent laparoscopy and laparotomy surgery and repair of the ruptured peptic ulcer. The length of the patients' surgery was recorded in both groups. Also, patients after surgery have been measured in terms of pain with VAS criteria. The increasing and decreasing rate of leukocytosis and also based on the conditions of each patient, the appropriate time for the patient to po is recorded. During hospitalization, the patients were examined in terms of the rate of surgical site infection, the rate of pneumonia, pulmonary embolism, anastomosis site leak, and intra-abdominal abscesses, and the duration of hospitalization, and they were followed up for one month. Results: In this study, 20 laparoscopy patients and 32 laparotomy patients were performed, and the average pain level of the vas scale in the laparoscopy group was 3.8 and in the laparotomy group was 5.2 with a significant p-value (0.001). The amount of npo in laparoscopy was significantly less with p-value(0.006).