Laparoscopic closure of perforated gastro-duodenal ulcer: 15 years' experience in our centre

Introduction: The objective of the study is to share the results and development findings on the laparoscopic closure technique applied in our centre during a 15-year period (1998-2012).

Aim: To compare statistically the standard parameters (hospitalization, duration of operation) versus conventional surgery, and at the same time we compared mainly morbidity and mortality.

Material and methods: During the period under review we operated on a total of 259 patients, 115 (44.4%) of them laparoscopically, and 144 (55.6%) of them conventionally. The sample was divided into two groups: patients with ASA physical status classification system 1-3, and patients with ASA 4-5.

Results: The results favour laparoscopy within the group with ASA 1-3 in terms of several parameters, namely: duration of hospitalization - 7.7 days in the case of laparoscopic intervention, vs. 10.6 days for conventional surgery (p < 0.05); and duration of operation - 61 min vs. 85.1 min respectively (p < 0.05). Total morbidity was 27.5% in the case of patients with conventional surgery, vs. 10.9% with laparoscopic intervention (p < 0.05). The sample of patients with ASA 4-5 suffered a high mortality of 82.7%.

Conclusions: Laparoscopic closure of perforated ulcer is a safe therapeutic method, as confirmed by the results of many other studies around the world, which in many aspects favour the laparoscopic technique.