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Laparoscopic Repair of Perforated Ulcer in Western Denmark
Thorbjorn Sommer*1, Henrik Elbroend1, Hans F. Andersen2
1Surgery, Randers Regionshospital, Randers, Denmark; 2Surgery, Horsens Regionshospital, Horsens, Denmark
Objective: To report the distribution and results of laparoscopic repair of perforated ulcer surgery in surgical departments in a major region in Denmark and compare it with the results from the national database regarding mortality and morbidity. Method: Case charts from all patients who underwent laparoscopic repair of perforated ulcer in Western Denmark in the period 1 January 2003 - 1 July 2007 were collected. Demographical data, surgical details, morbidity, 30 day mortality, and length of stay were recorded. For comparison, data from the National Health Registry (NIP) describing all patients who had an operation due to perforated ulcer in this period was obtained.Results: No more than 51 out of 818 patients undergoing operation for perforated ulcer in the region had a laparoscopic operation. Mortality in the laparoscopic group was 4 % compared to 26 % reported from the national database (NIP). The laparoscopic group had a higher reperforation rate, but length of stay was equal. No formal criteria concerning surgeon or patients selection for laparoscopic surgery were met.Conclusion: Laparoscopic repair of perforated ulcer was done without any selection criteria in few surgical departments in Western Denmark and was associated with a low mortality but a higher risk of reperforation.
Complications after surgery.
Laparoscopic Jytland | NIP data Jytland | NIP data Denmark | |
Patients (n) | 51 | 818 | 1714 |
30 day Mortality (%) | 4 | 25 | 28 |
Reperforation (%) | 10 | 5 | 4 |
Other reoperation(%)* | 10 | 14 | 14 |
Length of stay (days)** | 7 (2-57) | 8 (13-16) | 8(13-15) |
* including drainage** median/range
Operative data laparoscopic repairs
Perforation | 51 |
Duodenum | 35 |
Gastric | 16 |
Suturering alone | 12 |
Suturing with omentoplasty | 39 |
Postoperative nasogastric drainage (days) | 3(0-10) |
Oral feeding start day | 4(0-13) |
Antibiotics (days) | 3(0-18) |
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