![]() Laparoscopic repair offers advantages of a minimally invasive approach (smaller incisions requiring less postoperative opioid analgesics, fewer wound complications, and lower cardiopulmonary morbidity) however, laparoscopic repair requires technically advanced intracorporeal suturing skills which limits its availability in the general surgical population. #KLIPPED N PLUGGED PATCH#Laparoscopic omental patch repair for perforated ulcers has been shown to be a feasible and safe procedure in selected patients. A well-vascularized omental pedicle is brought to the site of perforation and the hole is sealed with the omentum being tacked into place. If the impact of post-interventional adverse events or "second hit" could be reduced, improvement in morbidity and mortality may be achieved.Ĭurrently, an open operative approach is most frequently employed for treatment of perforated ulcers, often using the repair described by Graham about 60 years ago. A recent study reported three parameters to be predictors of death after hospital stay: concomitant diseases (p = 0.001), post-interventional adverse events (p = 0.002), and age (p = 0.049).Īge and comorbities are not factors that can be altered. In-hospital mortality rates range between 5% and 24%. Seventy percent of deaths associated with peptic ulcer disease are attributed to perforation. ![]()
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