Outcome After Laparoscopic Surgery for Peptic Ulcer Perforation

Despite advances in laparoscopic surgery for perforated peptic ulcer (PPU), intra-abdominal abscess (IAA) is recognized as one of the commonly reported complications with relation to the extent of infectious abdominal contamination. Herein, the investigators report their experience of laparoscopic surgery for PPU with/without peritoneal irrigation and discuss postoperative outcome. The investigators retrospectively examined the electronic medical records of the patients who underwent laparoscopic surgery for perforated peptic ulcer at a single medical center in Taiwan between January 2013 and August 2021. Retrospectively, the investigators would include those patients with clinical diagnosis of PPU who underwent emergent laparoscopic surgery. The patients with previous abdominal surgery, pathologic confirmed malignant ulcer perforation or concomitant ulcer bleeding were excluded. The investigators focused on post-operative complications and outcome after laparoscopic surgery with or without peritoneal irrigation. This information can be important in improving surgical options with respect to risk and potential benefits in this setting.

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Key information

Conditions

Intraabdominal Abscess After Procedure Abdominal Abscess Abscess Digestive System Diseases Duodenal Diseases Gastrointestinal Diseases Infections Intestinal Diseases Leakage Lung Diseases Operation Wound; Infection Pathologic Processes Pathological Conditions, Signs and Symptoms Peptic Ulcer Peptic Ulcer Perforation Pneumonia Postoperative Complications Respiratory Tract Diseases Respiratory Tract Infections Stomach Diseases Suppuration Surgical Wound Infection Wound Infection

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Observational

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

The patients with clinical diagnosis of PPU underwent laparoscopic repair surgery.

Exclusion criteria

The patients received surgery in an open approach or underwent laparoscopy initially but then intraoperatively converted to laparotomy.

Treatment and study plan

Peritoneal irrigation

Procedure

For patients allocated to the irrigation group, peritoneal lavage was performed at the surgeon's discretion based on surgical findings and preference.

suction only

Procedure

In the suction only group, one surgical gauze each was placed in the splenophrenic space and Morison's pouch to soak up any remaining purulent fluid followed by turning the patient into the Trendelenburg position for inspection of the lower abdominal cavity. Any interloop adhesions were carefully divided and the gauze-wiping maneuver was used to soak up the residual peritoneal fluid, and all bowel loops were investigated to the root of the mesentery.

Primary outcomes

Short-term outcome with wound infection, pneumonia, leakage, and intraabdominal abscess

Time frame: Through hospitalization, an average of 8 days

Complication grading used clavien dindo classification

Sponsors and collaborators

Lead sponsor

Chang Wei-Jung

Other

Registry information

Official study title

Whether Peritoneal Irrigation Intra-operatively Effects on the Outcome After Laparoscopic Surgery for Peptic Ulcer Perforation

Important dates

Study start: 2013
Primary completion: 2021
Study completion: 2021
First posted: Dec 7, 2021
Registry last updated: Dec 7, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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