Outcome of Duodenal Ulcer Perforation After Graham Omental Patch Repair

Abstract

Objective: To determine the outcome of Graham Omental patch repair in duodenal ulcer perforation at Liaquat medical University Hospital Hyderabad. Settings: This study was conducted in the Department of General Surgery at Liaquat University of Medical and health science. Study design: Descriptive, case series. Duration: One year, from August 2016 to July 2017. Methodology: All cases with diagnosis of perforated duodenal ulcer within 48 hours, aged between 15 to 60 years and either of gender were included. Complete clinical examination including ultrasound of abdomen, abdominal and chest erect X-ray exhibiting air under the diaphragm were done. All the cases according to the clinical conditions were resuscitated and operated in the emergency. Outcome of Graham omental patch repair was documented in terms of complications and mortality. All the data was entered on predesigned proforma. Results: Total 195 patients were selected; their mean age was 43.11+03.36 years. Males were in majority 60.0%. 23.1% cases were smokers, hypertensive 8.2%, diabetes 5.1% and obese patients were 3.6%. According to the outcome wound infection was developed among 6.2% cases, chest infections 3.6% cases, Intra-abdominal abscesses 4.1% cases, renal failure occurred among 3.1% cases and post-operative leak found in 3.6% of the cases, while 3.1% patients were reopened and mortality rate was observed 5.1%. Factors like old age, diabetes, hypertension, obesity and smoking were significantly associated with poor outcome and mortality, p-value 0.001. Conclusion: It was concluded that Omental patch repair is simple to perform and yet remains reliable for the closure of much large perforations. Patch closure only is sufficient in case of duodenal perforations considering the low complication rate. Co-morbidities had significant effects on outcome.