J Minim Invasive Surg.  2019 Mar;22(1):23-28. 10.7602/jmis.2019.22.1.23.

Laparoscopic Single Figure of Eight Suturing Omentopexy for the Treatment of a Perforated Duodenal Ulcer

Affiliations
  • 1Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. ho115.kim@samsung.com

Abstract

PURPOSE
Safe and effective surgical treatment of peptic ulcer perforations is fundamental to achieve favorable outcomes. We present laparoscopic single figure of eight suturing omentopexy for perforated duodenal ulcer and review associated clinical outcomes. This is a new formulaic surgical technique for laparoscopic omentopexy.
METHODS
Laparoscopic single figure of eight suturing omentopexies for perforated duodenal ulcer were completed in 15 consecutive patients between April 2008 and November 2017 at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. Using prospectively collected data, we performed an observational study on an intention-to-treat basis.
RESULTS
The mean age of the 15 patients who underwent laparoscopic repair was 41.7±13.9 years. The perforation site was the anterior duodenal bulb in all patients. The median perforation size was 5 mm (range: 3~8 mm). The mean operation time was 66.7±19.6 minutes. There was no evidence of leakage from the omentopexy site clinically or in the postoperative upper gastrointestinal series. One patient (6.7%) experienced the postoperative complication of pneumothorax. There were no cases of postoperative mortality or reoperation within 30 days after surgery. The median time to tolerance of regular diet was 6 (range: 4~9) days. The median postoperative hospital stay was 7 days (range: 5~11 days).
CONCLUSION
Laparoscopic single figure of eight suturing omentopexy can be a viable option in the surgical management of perforated duodenal ulcer in selected patients without surgical risk factors. Laparoscopic single figure of eight suturing omentopexy is safe and easy to perform, and may therefore reduce operation time.

Keyword

Peptic ulcer perforation; Duodenal ulcer; Laparoscopy; Omentopexy

MeSH Terms

Diet
Duodenal Ulcer*
Humans
Korea
Laparoscopy
Length of Stay
Mortality
Observational Study
Peptic Ulcer Perforation
Pneumothorax
Postoperative Complications
Prospective Studies
Reoperation
Risk Factors
Seoul
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