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The Causes of Conversion from Laparoscopy to Laparotomy in Patients with Laparoscopic Repair of Perforated Peptic Ulcer

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=54103#.VO1-SCzQrzE

ABSTRACT
Purpose: Perforated peptic ulcer is an emergency condition. Laparoscopic ulcer repair is a feasible and safe procedure. The aim of this study was to research the efficacy of laparoscopic repair of peptic ulcer and to discuss the causes of conversion from laparoscopy to laparotomy. Methods: We collected 34 patients with perforated peptic ulcer underwent laparoscopic surgery from October 2003 to October 2008. Thirty four patients with perforated peptic ulcer underwent laparoscopic intervention and 6 cases were converted to laparotomy. The demographics, laboratory data, perioperative data, morbidity and mortality were compared. Results: In demographics of two groups, there were no significant differences in sex, age, location, and mean duration of symptoms of acute abdominal pain. However, there were significant differences in median size of perforation, mean duration of history of peptic ulcer related pain, and the experiences of surgeon. There were no significant differences in the laboratory data and perioperative data of two groups. In morbidity and mortality of two groups, there were no significant differences in leakage, wound infection, intra-abdominal abscess, ileus, urinary tract infection, pneumonia, and mortality, but there was significant difference in overall morbidity in two groups. Conclusions: Laparoscopic repair of perforated peptic ulcer is safe and could be used in routine clinical practice. However, patients with larger perforations (>10 mm), longer duration of history peptic ulcer related pain (>2 years), and learning curve of surgeon could be associated with conversion rate. It is associated with higher morbidity in patients with conversion from laparoscopy to laparotomy.
Cite this paper
Lin, C. , Chou, D. , Lee, Y. and Wu, H. (2015) The Causes of Conversion from Laparoscopy to Laparotomy in Patients with Laparoscopic Repair of Perforated Peptic Ulcer. Surgical Science, 6, 75-79. doi: 10.4236/ss.2015.62013.
 
References
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[2]Koo, J., Ngan, Y.K. and Lam, S.K. (1983) Trends in Hospital Admissions, Perforation and Mortality of Peptic Ulcer in Hong Kong from 1970 to 1980. Gastroenterology, 84, 1558-1562.
 
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[4]Rodríguez-Sanjuán, J.C., Fernández-Santiago, R., García, R.A., et al. (2005) Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication. World Journal of Surgery, 29, 849-852. http://dx.doi.org/10.1007/s00268-005-7797-x
 
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[6]Gunshefski, L., Flancbaum, L., Brolin, R.E., et al. (1990) Changing Patterns in Perforated Peptic Ulcer Disease. The American Surgeon, 56, 270-274.
 
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[10]Siu, W.T., Chau, C.H., Law, B.B., et al. (2004) Routine Use of Laparoscopic Repair for Perforated Peptic Ulcer. British Journal of Surgery, 91, 481-484. http://dx.doi.org/10.1002/bjs.4452              eww150225lx
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