Laparoscopic repair of perforated duodenal ulcers -: Outcome and efficacy in 30 consecutive patients

Hypothesis: Laparoscopic management of perforated duodenal ulcers is safe and effective. Design: Prospective nonrandomized controlled trial. Setting: Tertiary care academic center. Patients and Methods: Between October 1993 and October 1997, 30 patients underwent laparoscopic Graham patch repair of perforated duodenal ulcers and 16 had an open repair. Main Outcome Measures: Morbidity, operating time, analgesic requirements, length of hospital stay, and time to return to work. Results: There was no difference in morbidity between the 2 groups. Operating time was longer in the laparoscopy group (106 vs 63 minutes; P = .001). Patients with shock on admission or symptoms for more than 24 hours had a higher conversion rate (P < .05). The laparoscopy group required fewer analgesics, had a shorter stay, and a quicker recovery. Conclusions: Laparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.