Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers

Yu-Chun Wang; Chi-Hsun Hsieh; Hung-Chieh Lo; Li-Ting Su

doi:10.1007/s00268-014-2503-5

Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers

Yu-Chun Wang, Chi-Hsun Hsieh, Hung-Chieh Lo, Li-Ting Su

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Background: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Methods: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. Results: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. Conclusions: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU. © 2014 Société Internationale de Chirurgie.

Original language	English
Pages (from-to)	1917-1921
Number of pages	5
Journal	World Journal of Surgery
Volume	38
Issue number	8
DOIs	https://doi.org/10.1007/s00268-014-2503-5
Publication status	Published - 2014
Externally published	Yes

Keywords

adult
aged
cohort analysis
comparative study
evaluation study
female
human
laparoscopy
male
middle aged
omentum
operation duration
Peptic Ulcer Perforation
procedures
retrospective study
suturing method
treatment outcome
very elderly
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Laparoscopy
Male
Middle Aged
Omentum
Operative Time
Retrospective Studies
Suture Techniques
Treatment Outcome

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10.1007/s00268-014-2503-5

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Cite this

@article{8725848f48994d6387eb918a02b9a48e,

title = "Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers",

abstract = "Background: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Methods: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. Results: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. Conclusions: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU. {\textcopyright} 2014 Soci{\'e}t{\'e} Internationale de Chirurgie.",

keywords = "adult, aged, cohort analysis, comparative study, evaluation study, female, human, laparoscopy, male, middle aged, omentum, operation duration, Peptic Ulcer Perforation, procedures, retrospective study, suturing method, treatment outcome, very elderly, Adult, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Laparoscopy, Male, Middle Aged, Omentum, Operative Time, Retrospective Studies, Suture Techniques, Treatment Outcome",

author = "Yu-Chun Wang and Chi-Hsun Hsieh and Hung-Chieh Lo and Li-Ting Su",

note = "Export Date: 24 March 2016 CODEN: WJSUD 通訊地址: Wang, Y.-C.; Department of Acute Care Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung 404, Taiwan; 電子郵件： [email protected] 參考文獻: Mahvi, D.M., Keantz, S.B., Stomach (2012) Sabiston Textbook of Surgery, pp. 1182-1226. , C.M. Townsend R.D. Beauchamp B.M. Evers K.L. Mattox (eds) 19 Elsevier Saunders Philadelphia 10.1016/B978-1-4377-1560-6.00049-4; Nathanson, L.K., Easter, D.W., Cuschieri, A., Laparoscopic repair/peritoneal toilet of perforated duodenal ulcer (1990) Surg Endosc, 4, pp. 232-233. , 1:STN:280:DyaK3M7ltVShsg%3D%3D 2149782 10.1007/BF00316801; Katkhouda, N., Mavor, E., Mason, R.J., Campos, G.M.R., Soroushyari, A., Berne, T.V., Laparoscopic repair of perforated duodenal ulcers: Outcome and efficacy in 30 consecutive patients (1999) Archives of Surgery, 134 (8), pp. 845-850. , DOI 10.1001/archsurg.134.8.845; Mehendale, V.G., Shenoy, S.N., Joshi, A.M., Chaudhari, N.C., Laparoscopic versus open surgical closure of perforated duodenal ulcers: A comparative study (2002) Indian Journal of Gastroenterology, 21 (6), pp. 222-224; Druart, M.L., Van Hee, R., Etienne, J., Cadiere, G.B., Gigot, J.F., Legrand, M., Limbosch, J.M., Yvergneaux, J.P., Laparoscopic repair of perforated duodenal ulcer: A prospective multicenter clinical trial (1997) Surgical Endoscopy, 11 (10), pp. 1017-1020; Bertleff, M.J., Lange, J.F., Laparoscopic correction of perforated peptic ulcer: First choice? A review of literature (2010) Surg Endosc, 24, pp. 1231-1239. , 2869436 20033725 10.1007/s00464-009-0765-z; Boey, J., Choi, S.K.Y., Poon, A., Alagaratnam, T.T., Risk stratification in perforated duodenal ulcers: A prospective validation of predictive factors (1987) Annals of Surgery, 205 (1), pp. 22-26; Linder, M.M., Wacha, H., Feldmann, U., The Mannheim Peritonitis Index. An instrument for the intraoperative prognosis of peritonitis (1987) Chirurg, 58, pp. 84-92. , 1:STN:280:DyaL2s7ovFeiug%3D%3D 3568820; Lagoo, S., McMahon, R.L., Kakihara, M., The sixth decision regarding perforated duodenal ulcer (2002) JSLS, 6, pp. 359-368. , 3043448 12500837; Lau, H., Laparoscopic repair of perforated peptic ulcer: A meta-analysis (2004) Surgical Endoscopy, 18 (7), pp. 1013-1021; Darzi, A., Cheshire, N.J., Somers, S.S., Super, P.A., Guillou, P.J., Monson, J.R.T., Laparoscopic omental patch repair of perforated duodenal ulcer with an automated stapler (1993) British Journal of Surgery, 80 (12), p. 1552. , DOI 10.1002/bjs.1800801221; Costalat, G., Dravet, F., Noel, P., Coelioscopic treatment of perforated gastroduodenal ulcer using the ligamentum teres hepatis (1991) Surg Endosc, 5, pp. 154-155. , 1:STN:280:DyaK387gvVGksw%3D%3D 1837189 10.1007/BF02653225; Pescatore, P., Halkic, N., Calmes, J.-M., Blum, A., Gillet, M., Combined laparoscopic-endoscopic method using an omental plug for therapy of gastroduodenal ulcer perforation (1998) Gastrointestinal Endoscopy, 48 (4), pp. 411-414. , DOI 10.1016/S0016-5107(98)70013-6; Lau, W.-Y., Leung, K.-L., Kwong, K.-H., Davey, I.C., Robertson, C., Dawson, J.J.W., Chung, S.C.S., Li, A.K.C., A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique (1996) Annals of Surgery, 224 (2), pp. 131-138. , DOI 10.1097/00000658-199608000-00004; Ates, M., Sevil, S., Bakircioglu, E., Colak, C., Laparoscopic repair of peptic ulcer perforation without omental patch versus conventional open repair (2007) Journal of Laparoendoscopic and Advanced Surgical Techniques, 17 (5), pp. 615-619. , DOI 10.1089/lap.2006.0195; Seelig, M.H., Seelig, S.K., Behr, C., Schonleben, K., Comparison between open and laparoscopic technique in the management of perforated gastroduodenal ulcers (2003) Journal of Clinical Gastroenterology, 37 (3), pp. 226-229. , DOI 10.1097/00004836-200309000-00007; Lo, H.C., Wu, S.C., Huang, H.C., Laparoscopic simple closure alone is adequate for low risk patients with perforated peptic ulcer (2011) World J Surg, 35, pp. 1873-1878. , 10.1007/s00268-011-1106-7 21533964 10.1007/s00268-011-1106-7; Ates, M., Dirican, A., The simple suture laparoscopic repair of peptic ulcer perforation without an omental patch (2012) Surg Endosc, 26, p. 289. , 1:STN:280:DC%2BC38%2FosVKjsg%3D%3D 21898018 10.1007/s00464-011-1878-8; Inoh, K., Muramatsu, H., Ochiai, K., Torii, S., Muramatsu, T., Midkine, a heparin-binding cytokine, plays key roles in intraperitoneal adhesions (2004) Biochemical and Biophysical Research Communications, 317 (1), pp. 108-113. , DOI 10.1016/j.bbrc.2004.03.015, PII S0006291X04004863; Wang, Y.C., Fu, C.Y., Chen, R.J., Comparison between laparoscopic and open repair of perforated peptic ulcer disease in the elderly (2011) Am Surg, 77, pp. 803-804. , 21679660",

year = "2014",

doi = "10.1007/s00268-014-2503-5",

language = "English",

volume = "38",

pages = "1917--1921",

journal = "World Journal of Surgery",

issn = "0364-2313",

publisher = "John Wiley and Sons Inc.",

number = "8",

}

TY - JOUR

T1 - Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers

AU - Wang, Yu-Chun

AU - Hsieh, Chi-Hsun

AU - Lo, Hung-Chieh

AU - Su, Li-Ting

N1 - Export Date: 24 March 2016 CODEN: WJSUD 通訊地址: Wang, Y.-C.; Department of Acute Care Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung 404, Taiwan; 電子郵件： [email protected] 參考文獻: Mahvi, D.M., Keantz, S.B., Stomach (2012) Sabiston Textbook of Surgery, pp. 1182-1226. , C.M. Townsend R.D. Beauchamp B.M. Evers K.L. Mattox (eds) 19 Elsevier Saunders Philadelphia 10.1016/B978-1-4377-1560-6.00049-4; Nathanson, L.K., Easter, D.W., Cuschieri, A., Laparoscopic repair/peritoneal toilet of perforated duodenal ulcer (1990) Surg Endosc, 4, pp. 232-233. , 1:STN:280:DyaK3M7ltVShsg%3D%3D 2149782 10.1007/BF00316801; Katkhouda, N., Mavor, E., Mason, R.J., Campos, G.M.R., Soroushyari, A., Berne, T.V., Laparoscopic repair of perforated duodenal ulcers: Outcome and efficacy in 30 consecutive patients (1999) Archives of Surgery, 134 (8), pp. 845-850. , DOI 10.1001/archsurg.134.8.845; Mehendale, V.G., Shenoy, S.N., Joshi, A.M., Chaudhari, N.C., Laparoscopic versus open surgical closure of perforated duodenal ulcers: A comparative study (2002) Indian Journal of Gastroenterology, 21 (6), pp. 222-224; Druart, M.L., Van Hee, R., Etienne, J., Cadiere, G.B., Gigot, J.F., Legrand, M., Limbosch, J.M., Yvergneaux, J.P., Laparoscopic repair of perforated duodenal ulcer: A prospective multicenter clinical trial (1997) Surgical Endoscopy, 11 (10), pp. 1017-1020; Bertleff, M.J., Lange, J.F., Laparoscopic correction of perforated peptic ulcer: First choice? A review of literature (2010) Surg Endosc, 24, pp. 1231-1239. , 2869436 20033725 10.1007/s00464-009-0765-z; Boey, J., Choi, S.K.Y., Poon, A., Alagaratnam, T.T., Risk stratification in perforated duodenal ulcers: A prospective validation of predictive factors (1987) Annals of Surgery, 205 (1), pp. 22-26; Linder, M.M., Wacha, H., Feldmann, U., The Mannheim Peritonitis Index. An instrument for the intraoperative prognosis of peritonitis (1987) Chirurg, 58, pp. 84-92. , 1:STN:280:DyaL2s7ovFeiug%3D%3D 3568820; Lagoo, S., McMahon, R.L., Kakihara, M., The sixth decision regarding perforated duodenal ulcer (2002) JSLS, 6, pp. 359-368. , 3043448 12500837; Lau, H., Laparoscopic repair of perforated peptic ulcer: A meta-analysis (2004) Surgical Endoscopy, 18 (7), pp. 1013-1021; Darzi, A., Cheshire, N.J., Somers, S.S., Super, P.A., Guillou, P.J., Monson, J.R.T., Laparoscopic omental patch repair of perforated duodenal ulcer with an automated stapler (1993) British Journal of Surgery, 80 (12), p. 1552. , DOI 10.1002/bjs.1800801221; Costalat, G., Dravet, F., Noel, P., Coelioscopic treatment of perforated gastroduodenal ulcer using the ligamentum teres hepatis (1991) Surg Endosc, 5, pp. 154-155. , 1:STN:280:DyaK387gvVGksw%3D%3D 1837189 10.1007/BF02653225; Pescatore, P., Halkic, N., Calmes, J.-M., Blum, A., Gillet, M., Combined laparoscopic-endoscopic method using an omental plug for therapy of gastroduodenal ulcer perforation (1998) Gastrointestinal Endoscopy, 48 (4), pp. 411-414. , DOI 10.1016/S0016-5107(98)70013-6; Lau, W.-Y., Leung, K.-L., Kwong, K.-H., Davey, I.C., Robertson, C., Dawson, J.J.W., Chung, S.C.S., Li, A.K.C., A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique (1996) Annals of Surgery, 224 (2), pp. 131-138. , DOI 10.1097/00000658-199608000-00004; Ates, M., Sevil, S., Bakircioglu, E., Colak, C., Laparoscopic repair of peptic ulcer perforation without omental patch versus conventional open repair (2007) Journal of Laparoendoscopic and Advanced Surgical Techniques, 17 (5), pp. 615-619. , DOI 10.1089/lap.2006.0195; Seelig, M.H., Seelig, S.K., Behr, C., Schonleben, K., Comparison between open and laparoscopic technique in the management of perforated gastroduodenal ulcers (2003) Journal of Clinical Gastroenterology, 37 (3), pp. 226-229. , DOI 10.1097/00004836-200309000-00007; Lo, H.C., Wu, S.C., Huang, H.C., Laparoscopic simple closure alone is adequate for low risk patients with perforated peptic ulcer (2011) World J Surg, 35, pp. 1873-1878. , 10.1007/s00268-011-1106-7 21533964 10.1007/s00268-011-1106-7; Ates, M., Dirican, A., The simple suture laparoscopic repair of peptic ulcer perforation without an omental patch (2012) Surg Endosc, 26, p. 289. , 1:STN:280:DC%2BC38%2FosVKjsg%3D%3D 21898018 10.1007/s00464-011-1878-8; Inoh, K., Muramatsu, H., Ochiai, K., Torii, S., Muramatsu, T., Midkine, a heparin-binding cytokine, plays key roles in intraperitoneal adhesions (2004) Biochemical and Biophysical Research Communications, 317 (1), pp. 108-113. , DOI 10.1016/j.bbrc.2004.03.015, PII S0006291X04004863; Wang, Y.C., Fu, C.Y., Chen, R.J., Comparison between laparoscopic and open repair of perforated peptic ulcer disease in the elderly (2011) Am Surg, 77, pp. 803-804. , 21679660

PY - 2014

Y1 - 2014

N2 - Background: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Methods: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. Results: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. Conclusions: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU. © 2014 Société Internationale de Chirurgie.

AB - Background: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Methods: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. Results: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. Conclusions: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU. © 2014 Société Internationale de Chirurgie.

KW - adult

KW - aged

KW - cohort analysis

KW - comparative study

KW - evaluation study

KW - female

KW - human

KW - laparoscopy

KW - male

KW - middle aged

KW - omentum

KW - operation duration

KW - Peptic Ulcer Perforation

KW - procedures

KW - retrospective study

KW - suturing method

KW - treatment outcome

KW - very elderly

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Female

KW - Humans

KW - Laparoscopy

KW - Male

KW - Middle Aged

KW - Omentum

KW - Operative Time

KW - Retrospective Studies

KW - Suture Techniques

KW - Treatment Outcome

U2 - 10.1007/s00268-014-2503-5

DO - 10.1007/s00268-014-2503-5

M3 - Article

SN - 0364-2313

VL - 38

SP - 1917

EP - 1921

JO - World Journal of Surgery

JF - World Journal of Surgery

IS - 8

ER -

Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers

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Keywords

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