TITLE:
The Causes of Conversion from Laparoscopy to Laparotomy in Patients with Laparoscopic Repair of Perforated Peptic Ulcer
AUTHORS:
Chien-Hua Lin, Der-Ao Chou, Yueh-Tsung Lee, Hurng-Sheng Wu
KEYWORDS:
Laparoscopy, Perforated Peptic Ulcer, Repair, Conversion Rate
JOURNAL NAME:
Surgical Science,
Vol.6 No.2,
February
15,
2015
ABSTRACT: Purpose: Perforated peptic ulcer is an
emergency condition. Laparoscopic ulcer repair is a feasible and safe
procedure. The aim of this study was to research the efficacy of laparoscopic
repair of peptic ulcer and to discuss the causes of conversion from laparoscopy
to laparotomy. Methods: We collected 34 patients with perforated peptic ulcer
underwent laparoscopic surgery from October 2003 to October 2008. Thirty four
patients with perforated peptic ulcer underwent laparoscopic intervention and 6
cases were converted to laparotomy. The demographics, laboratory data,
perioperative data, morbidity and mortality were compared. Results: In
demographics of two groups, there were no significant differences in sex, age,
location, and mean duration of symptoms of acute abdominal pain. However, there
were significant differences in median size of perforation, mean duration of
history of peptic ulcer related pain, and the experiences of surgeon. There
were no significant differences in the laboratory data and perioperative data
of two groups. In morbidityand
mortality of two groups, there were no significant differences in leakage,
wound infection, intra-abdominal abscess, ileus, urinary tract infection,
pneumonia, and mortality, but there was significant difference in overall
morbidity in two groups. Conclusions: Laparoscopic repair of perforated peptic
ulcer is safe and could be used in routine clinical practice. However, patients
with larger perforations (>10 mm), longer duration of history peptic ulcer
related pain (>2 years), and learning curve of surgeon could be associated
with conversion rate. It is associated with higher morbidity in patients with
conversion from laparoscopy to laparotomy.