1 research outputs found
Laparoscopic treatment for perforated duodenal ulcer
Clinica de Chirurgie 2, UMF āVictor BabeČā TimiČoara, Clinica de Chirurgie, UMF āCarol Davilaā, BucureČti, Clinica de Chirurgie 2, UMF āGrigore T Popaā, IaČi, Clinica de Chirurgie 2, Facultatea de MedicinÄ, Universitatea āOvidiusā,
ConstanČa, Clinica de Chirurgie 2, Facultatea de Medicina, Sibiu, Clinica de Chirurgie 1, UMF āIuliu HaČieganuā, Cluj-
Napoca, Departamentul de Chirurgie I, Facultatea de MedicinÄ, UMF Craiova, RomĆ¢nia, Al XII-lea Congres al AsociaČiei Chirurgilor āNicolae Anestiadiā din Republica Moldova cu participare internaČionalÄ 23-25 septembrie 2015Introducere: Acest studiu retrospectiv evalueazÄ rezultatele tratamentului laparoscopic Ć®n ulcerul duodenal perforat Či este
realizat Ć®n 7 spitale cu experienČÄ Ć®n chirurgia laparoscopica din RomĆ¢nia.
Material Či metode: Ćntre anii 2006 Či 2013, 297 pacienČi (48 femei, 249 bÄrbaČi) cu vĆ¢rste cuprinse Ć®ntre 18 Či 77 ani au fost
supuČi intervenČiei chirurgicale laparoscopice pentru ulcer duodenal perforat, cu utilizarea a 3 (61%), 4 (29%) sau 5 (10%)
trocare. Čaizeci Či doi (21%) dintre pacienČi au prezentat o formÄ uČoarÄ, 190 (64,1%) au prezentat o formÄ moderatÄ Či 45
(14,9%) o formÄ severÄ de peritonitÄ. Procedurile utilizate au fost: sutura simplÄ ā 118 (39,8%) pacienČi, sutura cu
epiplonoplastie ā 176 (59,5%), doar epiplonoplastie ā 1 (0,3%) pacient, excizie Či suturÄ ā 1 (0,3%) pacient.
Rezultate: Durata intervenČiilor a fost Ć®ntre 30 Či 120 minute, cu o medie de 65 minute. Mortalitatea a fost nulÄ. ComplicaČii:
infecČii parietale ā 3 (1%), fistule duodenale ā 3 (1%), abcese abdominale ā 2 (0,6%), hemoragii digestive ā 1 (0,3%) Či stenoza
duodenalÄ ā 1 (0,3%). Durata medie de spitalizare ā 5,5 zile. Ćn comparaČie cu tehnica clasica, pacienČii au necesitat mai puČine
analgetice Či antibiotice, cu 80% mai puČine pansamente Či au avut cu 70% mai puČine infecČii parietale Ć®n evoluČia
postoperatorie.
Concluzii: Tratamentul laparoscopic pentru ulcerul duodenal perforat, este recomandat chiar Či Ć®n cazurile cu peritonitÄ severÄ,
evoluČia postoperatorie fiind cu mai puČine complicaČii Či cu o recuperare mai rapidÄ faČa de procedura clasicÄ. Aceast abord
poate fi considerat āstandard de aurā Ć®n tratamentul ulcerului duodenal perforat.Introduction: This retrospective study evaluates results of the laparoscopic treatment of perforated duodenal ulcer obtained in
7 centers with experience in laparoscopic surgery from Romania.
Material and methods: A total of 297 (48 women and 249 men) patients with perforated duodenal ulcer underwent
laparoscopic intervention between 2006 and 2013, with ages 18 to 77 years. Three (61%), 4 (29%) or 5 (10%) trocars were
used. In 62 patients (21%) was diagnosed mild form of peritonitis, in 190 (64.1%) ā moderate and in 45 (14.9%) ā severe
peritonitis. Types of repair used in this study: simple suture ā 118 (39.8%) patients, suture with omental patch ā 176 (59.5%),
only sutured omental patch ā 1 (0.3%), excision and suture ā 1 (0.3%) patient.
Results: Operation time was between 30 and 120 min, with average of 65 min. Mortality rate was zero. Complications: parietal
infections ā 3 (1%), duodenal fistula ā 3 (1%), intraabdominal abscesses ā 2 (0.6%), digestive bleeding ā 1 (0.3%) and
duodenal stenosis ā 1 (0.3%). Average length of hospital stay ā 5.5 days. Patients treated using laparoscopic technique needed
less analgesics, antibiotics, 80% less dressing procedures and had 70% less surgical site infections in comparison to traditional
operation.
Conclusions: Laparoscopic treatment of perforated duodenal ulcer can be recommended even for patients with severe
peritonitis. This treatment is associated with fewer complications and more rapid recovery than traditional intervention.
Laparoscopic repair can be considered āgold standardā in the treatment of perforated duodenal ulcer