Laparoscopic Repair of Perforated Duodenal Ulcer using Suture and Suture Less Technique

Meraj Alam  Ansari; Bilal  Afsar; Saqib Uddin Khan; Muhammad  Kareemullah; Afsar Ali  Bhatti

doi:10.29054/apmc/2022.1354

Meraj Alam Ansari Post Graduate Resident, Department of Surgery, Lahore General Hospital, Lahore Pakistan
Bilal Afsar Post Graduate Resident, Department of Surgery, Sheikh Zayed Hospital, Lahore Pakistan
Saqib Uddin Khan Assistant Professor, Department of Surgery, University College of Medicine & Dentistry, University of Lahore, Lahore Pakistan
Muhammad Kareemullah Associate Professor, Department of Surgery, Lahore General Hospital, Lahore Pakistan
Afsar Ali Bhatti Professor, Department of Surgery, Lahore General Hospital, Lahore Pakistan

DOI: https://doi.org/10.29054/apmc/2022.1354

Keywords: Perforated duodenal ulcer, Open repair, Laparoscopic repair, Suture, Suture less techniques

Abstract

Background: Safety and feasibility of laparoscopic processes for the treatment of duodenal ulcer perforation have been fully recognized, repair with laparoscope has turn out to be an extensively frequent procedure of (perforated duodenal ulcer) PDU. The intent to feature an omental patch repair is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. Objective: To compare the outcome of laparoscopic repair in patients with perforated duodenal ulcer using suture and suture less techniques. Study Design: Randomized controlled trial. Settings: Department of Surgery, Lahore General Hospital, Lahore Pakistan. Duration: One year from January 2020 to December 2020. Methods: Total of 60 patients with perforated duodenal ulcer were included in this study and divided into two equal halves with 30 patients in each group. Group-1 where suture was used. Group-2 without suture. Groups were named suture group and suture less group according to the procedure they had. After discharge patients were followed-up in OPD for the duration of 30 days. Two groups were compared in terms of operating time, duration of hospital stay, having complications i.e. leakage, recurrence and wound infections. Results: Operating time and hospital stay were found to be significantly short in Group-2 as compared to Group-1, i.e. operating time [Group-1: 1.56 ± 0.14 hours vs Group-2: 1.01 ± 0.03 hours, p-value= <0.01] & hospital stay [Group-1: 3.07 ± 0.25 days vs. Group-2: 2.03 ± 0.18 days, p-value= <0.01]. The leakage and infection rate was statistically identical in both groups, p-value > 0.05. Conclusion: laparoscopic repair in patients with perforated duodenal ulcer Group-2 (using suture less techniques) has less operative time and can reduce the hospital stay.