Laparoscopic versus open repair of perforated peptic ulcers: analysis of outcomes and identification of predictive factors of conversion

• DOI: 10.1007/s13304-022-01391-6
• Publication Date: 2022-10-03T20:05:04Z
• Authors: Dario Tartaglia; Silvia Strambi; Federico Coccolini; Alessio Mazzoni; Mario Miccoli; Camilla Cremonini; Enrico Cicuttin; Massimo Chiarugi
• Keywords: Peptic; Identification

Abstract Background The surgical treatment for perforated peptic ulcers (PPUs) can be safely performed laparoscopically. This study aimed to compare the outcomes of patients who received different approaches PPU and identify predictive factors conversion open surgery. Methods retrospective analyzed treated PPUs from 2002 2020. Three groups were identified: a complete laparoscopic surgery group (LG), (CG), primary (OG). After univariate comparisons, multivariate analysis was conducted conversion. Results Of 175 that underwent PPU, 104 (59.4%) laparoscopic-first approach, 27 (25.9%) required Patients directly with an approach older ( p < 0.0001), had more comorbidities frequently previous laparotomy = 0.0001). In OG group, in-hospital mortality ICU need significantly higher, while postoperative stay longer. Previous abdominal (OR 0.086, 95% CI 0.012–0.626; 0.015), ulcer size 0.045, 0.010–0.210; posterior location 0.015, 0.001–0.400; 0.012) approach. Conclusion confirms benefits PPUs. laparotomies, greater size, are risk during repair.