Laparoscopic repair of perforated duodenal ulcers: outcome and efficacy in 30 consecutive patients.

HYPOTHESIS Laparoscopic management of perforated duodenal ulcers is safe and effective. DESIGN Prospective nonrandomized controlled trial. SETTING Tertiary care academic center. PATIENTS AND METHODS Between October 1993 and October 1997, 30 patients underwent laparoscopic Graham patch repair of perforated duodenal ulcers and 16 had an open repair. MAIN OUTCOME MEASURES Morbidity, operating time, analgesic requirements, length of hospital stay, and time to return to work. RESULTS There was no difference in morbidity between the 2 groups. Operating time was longer in the laparoscopy group (106 vs. 63 minutes; P = .001). Patients with shock on admission or symptoms for more than 24 hours had a higher conversion rate (P<.05). The laparoscopy group required fewer analgesics, had a shorter stay, and a quicker recovery. CONCLUSIONS Laparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.