Laparoscopic suturing of a perforated gastroduodenal ulcer
Tschudi, J.; Wagner, M.; Klaiber, C.
Schweizerische Medizinische Wochenschrift 124(29): 1281-1283
The mortality rate for perforated peptic ulcer ranges from 10 to 30%. Age above 70 years, preoperative shock, operation more than 24 hours from the time of acute onset, and poorly controlled concurrent illness are considered to be risk factors. Individuals with any of these features are deemed unfit for definitive surgery and should undergo simple omental patch suture alone. This case report details the laparoscopic management of an 86-year-old female with a ruptured duodenal peptic ulcer who was receiving corticosteroids and a non-steroidal antiinflammatory drug. Laparoscopy is of diagnostic value and permits efficient cleaning of the abdominal cavity. Provided the laparoscopic principles of management are essentially the same as those adhered to during open surgery, the minimally invasive procedure may help to reduce postoperative morbidity and mortality.