Laparoscopic treatment of perforated peptic ulcer.

Study objective : Contribution to evaluation of the place of laparoscopic surgery in the treatment of perforated peptic ulcer. Patients and methods: Between January 1992 and November 1997, 17 consecutive patients underwent laparoscopic suture of a perforated peptic ulcer, with or without omentoplasty. Results: Treatment was performed entirely by laparoscopy in 13 cases (76 %). The median operating time was 105 min (50-220 min). The median number of doses of analgesia administered to each patient was 8 (3-20 doses). The medium hospital stay was 6 days (2-23 days). Two patients (12%) died. Zn 11 cases, gastroscopy was performed between 1 and 4 months after the operation, revealing healing of the ulcer in 10 cases and persistence of the ulcer in one case. None of the patients were readmitted to hospital for ulcer complications, with a median follow-up of 35 months (1-63 months). Conclusion: The laparoscopic treatment of perforated duodenal is a technically simple and effective procedure, intermediate between conventional surgical treatment and Taylor's method. Laparoscopic surgery may therefore have a real place in the treatment of perforated peptic ulcer.