Perforated peptic ulcer: Laparoscopic approach

Objectives: To examine the suitability of a laparoscopic approach for treat ment of perforated peptic ulcer. Design: Retrospective non-randomised study. Setting: District Community Hospital. Methods: 30 patients who presented with perforated peptic ulcers between No vember 1992 and October 1997. Interventions: 16 patients were operated on laparoscopically, and 14 by ope n operation (as there was no surgeon available with laparoscopic experience ). Main outcome measures: Morbidity and mortality. Results: The laparoscopic operation was successful in all but one patient, whose operation was converted to an open procedure because we could not see the ulcer adequately. Duration of operation and postoperative nasogastric aspiration, analgesic requirements, hospital stay, morbidity, and mortality were similar in the two groups. Conclusions: Laparoscopic repair of a perforated peptic ulcer is safe in se lected patients in whom a laparotomy should be avoided.