Laparoscopic Repair of Perforated Duodenal Ulcer with Omental Patch

Background: Duodenal perforation is a common complication of duodenal ulcer. Treatment for perforated ulcer range from conservative treatment approach to radical surgery. Laparscopic management could be done, making it possible to avoid a median laparotomy which can lead to wound infection and late incisional hernia. We present our experience with the laparoscopic management of the perforated duodenal ulcer. Patients and methods: This study included 20 patients who underwent laparoscopic repair of perforated duodenal ulcer at our department. The patients were admitted in urgent setting. A detailed history was taken. The patients were well examined, and the time from the onset of symptoms to the beginning of the operation was recorded. The main diagnostic procedure performed was abdominal X-ray in erect position; in addition to abdominal ultrasound examination. Resuscitation was done preoperatively with I.V fluids and antibiotic. Results: The average operative time was 50 min (±15). 18 patients were operated upon laparoscopically, however 2 patients were converted to open procedure. Only 2 morbidities occurred, 1 patient developed leakage postoperatively which healed on conservative management and the other had sever post operative pneumonia. The average hospital stay was 5 days with no mortalities. Conclusion: Laparoscopic primary repair with omental patch is a good method for the surgical treatment of duodenal ulcer perforation, reducing hospital stay, complications and return to normal activity if carried on in a proper manner.