COMPARISON OF PERFORATED DUODENAL REPAIR OPEN VS LAPAROSCOPIC AND NATURE OF COMPLICATIONS

Abstract

Objective:
To compare the outcomes of laparoscopic versus open surgical procedures in patients with perforated duodenal ulcers.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Surgery, CMH Quetta from Oct 2024 to March 2025

Methodology:
This prospective observational study was conducted and included adult patients (≥18 years) diagnosed with perforated duodenal ulcers, confirmed preoperatively by imaging or intraoperatively during exploration. A total of 73 patients were enrolled based on a 5% prevalence rate. Patients were divided into two groups: Group A, which underwent open surgical duodenal repair, and Group B, which underwent laparoscopic duodenal repair. Patients eligible for either surgical approach were included. Demographic data, clinical variables, operative details, and postoperative outcomes were recorded and analyzed using SPSS version 26.0. Chi-square and independent t-tests were applied to compare variables between the two groups, with a p-value ≤0.05 considered statistically significant.

Results:
The mean age was 52.22+ 2.22 years, with no significant difference between Group A (54.53 years) and Group B (47.98 years). Males comprised 58.9% of patients, and comorbidities were present in 72.6%. Proton pump inhibitor use was higher in Group B (91.78%). Boey scores were significantly lower in Group B (0.7) compared to Group A (1.5) (p=0.04). Group B had smaller ulcer sizes (6.9 mm), shorter operative time (108 minutes), and lower postoperative morbidity (19.51%) compared to Group A (40.63%). ICU requirement was higher in Group A. Mortality rates and length of hospital stay were comparable between groups.

Conclusion:
Laparoscopic repair is a safe and effective treatment modality for perforated duodenal ulcers, offering reduced morbidity and operative time compared to open repair.