Safdar Bhatti, Naveed Muzaffar, Heba Jalloun, Abdullah Alawi, Mohammad Algari.
Managing Perforated Peptic Ulcer- a comparison between different approaches.
Pak J Med Health Sci Jan ;8(2):314-6.

Aim: To compare different treatment options for perforated peptic ulcer. Methods: This study was carried out in General Surgical department of Armed Forces Hospital, Jeddah, Saudi Arabia. It included patients from Jan 1, 2001 to Feb 28, 2014. All the patients diagnosed with perforated peptic ulcer either clinically or radiologically were included in the study. These patients were divided into three groups depending on the treatment option chosen which included, open and laparoscopic repair of perforation, and conservative management. All three approaches were compared in terms of morbidity, mortality, hospital stay and operating time. Results: A total of 50 patients were diagnosed with perforated peptic ulcer. Open repair was done for 30 patients. Laparoscopic repair was opted in 10 patients with 3 converted to open repair due to different reasons. The remaining 10 were tried for conservative treatment with success in 8 patients, while two had to undergo surgery. The laparoscopic repair group had significant advantage over the open and conservative group in terms of rate of morbidity (11% against 22% & 25%), mortality (9% against 15% & 12%) and mean hospital stay (8 days against 11 days & 12 days). However the operating time in laparoscopic repair group was more than the open repair group Conclusion: Although open repair is the conventional and most adopted approach in our study, the laparoscopic repair is superior in terms of morbidity, mortality and hospital stay. Conservative approach is also proved successful in selected cases and controlled settings.

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