Laparoscopic Repair of Perforated Peptic Ulcer: Simple Closure Versus Omentopexy

Abstract

Background: Laparoscopic repair of perforated peptic ulcer (PPU) has become an accepted way of management. Omentopexy was the main method of repair for decades.
Objective: The goal of the present study was to evaluate whether laparoscopic simple repair of PPU is as safe as omentopexy.
Patients and Methods: This prospective study included 50 patients who were diagnosed with perforated peptic ulcers and underwent laparoscopic repair of perforated peptic ulcers at our institute from September 2019 to September 2020. They were divided into two groups: Omentopexy (group A) (n=20) and repair with simple closure only (group B) (n=30). Patients’ age, sex, pulse, blood pressure, respiratory rate, Boey score, perforation size, operation time, leakage, wound infection, and length of hospital stay were evaluated. The data were compared by Mann-Whitney U test and the Pearson’s chi-square test.
Results: No patients died nor leaked. After matching, the simple closure and omentopexy groups had similarity in age, gender, pulse rate, respiratory rate, Boey score, perforation size and wound infection. There were statistically significant differences in systolic blood pressure (P = 0.002), operating time (136.40 ± 10.45 versus 106.83 ± 6.89 minutes; P < 0.0001), and length of hospital stay (7.20 ± 1.32 versus 5.67 ± 0.55; P < 0.0001).
Conclusion: Laparoscopic repair of a perforated peptic ulcer without an omental patch is a safe option and shortens the operating time.