Laparoscopic treatment of perforated peptic ulcer.

Study objective : Contribution to evaluation of the place of laparoscopic s urgery in the treatment of perforated peptic ulcer. Patients and methods: B etween January 1992 and November 1997, 17 consecutive patients underwent la paroscopic suture of a perforated peptic ulcer, with or without omentoplast y. 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 operatio n, 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 com plications, 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 treatme nt and Taylor's method. Laparoscopic surgery may therefore have a real plac e in the treatment of perforated peptic ulcer.