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Surgery Today
Published in: Surgery Today 11/2015

01-11-2015 | Original Article

Conversion of laparoscopic surgery for perforated peptic ulcer: a single-center study

Authors: Markus Zimmermann, Martin Hoffmann, Tilman Laubert, Carlo Jung, Hans-Peter Bruch, Erik Schloericke

Published in: Surgery Today | Issue 11/2015

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Abstract

Purpose

A perforated peptic ulcer can be managed laparoscopically in selected patients. The purpose of this study was to evaluate whether conversion of emergency laparoscopy is inferior to primary median laparotomy in terms of postoperative morbidity and mortality.

Methods

We analyzed patients who underwent laparoscopic or open surgery for a perforated peptic ulcer at the Department of Surgery, University of Schleswig–Holstein, Campus Luebeck between January, 1996 and December, 2010. Perforations were graded according to the Boey classification, a preoperative risk-scoring system.

Results

Conversion to laparotomy was necessary in 20 of the 45 patients who underwent laparoscopic surgery (CG); therefore, laparoscopic operations were completed in 25 patients (LG). The third patient cohort comprised 139 patients who underwent primary laparotomy (OG). Overall minor morbidity was significantly lower (p = 0.048) in the LG patients than in the OG patients, whereas no significant differences were found in major morbidity and mortality, particularly between the OG and CG.

Conclusion

Patients’ suitability for laparoscopic management should be decided on according to Boey’s clinical scoring system. Our findings demonstrated that conversion from laparoscopy to laparotomy was not associated with elevated postoperative morbidity or mortality versus initial laparotomy. Therefore, emergency operations may be commenced laparoscopically in selected patients, especially considering the postoperative advantages of this approach.
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Metadata
Title
Conversion of laparoscopic surgery for perforated peptic ulcer: a single-center study
Authors
Markus Zimmermann
Martin Hoffmann
Tilman Laubert
Carlo Jung
Hans-Peter Bruch
Erik Schloericke
Publication date
01-11-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 11/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1112-8

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