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COMPARATIVE STUDY OF LAPAROSCOPIC AND OPEN REPAIR OF DUODENAL ULCER PERFORATION

Background: Duodenal ulcer perforation is one of the common complications of duodenal ulcer disease despite the use of various anti-ulcer agents and eradication therapy. Laparoscopy has become increasingly popular in management of duodenal ulcer perforation. Aim of the Work: to compare between the efficacy and safety of laparoscopic and laparotomy repair of perforated duodenal ulcer in terms of operative time, postoperative pain, postoperative complication, Hospital stay and resuming normal activity. Patient and Methods, This prospective study included 50 patients with perforated duodenal peptic ulcer were admitted to the General Surgery Department in Ain Shams University Hospitals and Ahmed Maher Teaching Hospital from May 2016 to December 2017. The patients were divided by random serial number method into two groups: group A included 25 patients for laparoscopic procedure, and group B included 25 patients for open repair. Results: laparoscopic repair of perforated peptic ulcers is superior to the open repair as regards the postoperative pain, return of bowel habit, start of oral diet and length of hospitalization. Currently, the main drawbacks of laparoscopic repair are a longer operation and a higher incidence of intra-abdominal collection. The open repair has a higher rate of chest infection, wound infection. Suture leakage was reported in one case in the open group and in one case in laparoscopic group. Conclusion: laparoscopic repair of perforated peptic ulcers is a safe emergency procedure with many advantages such as less postoperative pain, early return of bowel habit, early start of oral diet, less length of hospitalization, good cosmetic outcome and less postoperative complications as(wound infections ,chest infections and incisional hernias).