Laparoscopic Repair of Perforated Duodenal Ulcers

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.