Abstract
Seventeen cases of gastric perforation and thirty-six cases of perforated duodenal ulcers treated with laparoscopic surgery accrued over the last thirteen years were studied. The etiologies of the gastric perforations were peptic ulcers in 14 patients, gastric cancer in 2 patients, and malignant lymphoma in 1 patient. Laparoscopic omental patch repair (LOPR) was performed in 12 of the 17 (70.6%) patients with gastric perforations. The mean operating time and hospital stay among these cases were 78 minutes and 16 days, respectively. Five other patients who could not be treated with LOPR underwent conversion to open surgery that included a distal gastrectomy in 1 patient and omenal patch repair in 4 patients. On the other hand, 32 of the 36 (88.9%) patients with perforated duodenal ulcers were treated using LOPR. The mean operating time and hospital stay of these patients were 61 minutes and 14.8 days, respectively. In conclusion, laparoscopic surgery may be effective, especially for the treatment of perforated duodenal ulcers because peritonitis caused by perforation can be sufficiently treated using this minimally invasive procedure. Since conservative treatment for upper GI tract perforation is also effective with restricted indications, treatment should be selected based on the physical condition of the patient.
