THE ROLE OF LAPAROSCOPY IN THE TREATMENT OF PERFORATIVE GASTRODUODENAL ULCERS

Abstract

Every year around the world gastric ulcer and duodenal ulcer affects about 4 million
people. Ulcer perforation is one of the most sever complication. The frequency of perforated
gastroduodenal ulcers (PGDU ) is 7–15% of the total number of patients with this condition. Mortality
varies from 3,3% to 17,5%. Currently, the most common operation is suturing the perforated cavity
with subsequent antiulcer therapy. In recent years, the laparoscopic method for suturing has become
widely used, which has several advantages over traditional operations. The goal of this study is to
improve the results of surgical treatment of patients with PGDU . The work is based on a retrospective
analysis of case studies of 168 patients with perforative ulcers treated at the Department of Faculty
Surgery named after prof. A. A . R usanov. Such diagnosis was established using the generally accepted
comprehensive diagnostic program. In the specialized methods Esophagogastroduodenoscopy
(EGD S) and diagnostic laparoscopy was used in the diagnostic process evaluation. All patients were
divided into two groups. The main group included 61 (36,3%) patients who underwent endoscopic
surgical intervention, control group — 107 (63,7%) patients after traditional suturing of perforated
ulcers. Conversion to laparotomy was required in 7 (4,2%) patients — there were no fatal outcomes
registered after laparoscopic suturing. Mortality in the control group was 10,1% (17 patients). The
results showed that the laparoscopic method of suturing is accompanied by a less pronounced pain
syndrome, activation of the patient, and a decrease in the number of postoperative complications,
mortality, and length of hospitalization.