Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic repair of perforated gastroduodenal ulcer by running suture

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background and aims

Perforated gastroduodenal ulcer represents an emergency situation that requires immediate surgical intervention. Laparoscopic ulcer repair is a feasible and safe procedure, especially in cases of a short duration of ulcer perforation and good clinical condition. However, to be well accepted as a treatment modality, an endoscopic procedure should be as simple as possible. We describe a technique that does not require intra-corporal or extra-corporal knotting.

Patients and methods

Over a 4-year period, we performed 786 diagnostic laparoscopies for various, acute abdominal conditions. We identified 20 gastroduodenal perforations. All ulcers were closed with a one-row running suture (Lahodny) and controlled radiologically on the third postoperative day.

Results

Three different surgeons performed the surgeries. There were no conversions to open surgery. Median operating time was 50 min, and median hospital stay was 9 days. We observed no insufficiency, no wound infection, and no stenosis or persisting peritonitis.

Conclusion

The closure of perforated gastric ulcers with the Lahodny suture is safe and simple to perform.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Lanas A, Serrano P, Bajador E, Esteva F, Benito R, Sainz R (1997) Evidence of aspirin use in both upper and lower gastrointestinal perforation. Gastroenterology 112:683–689

    CAS  PubMed  Google Scholar 

  2. Sánchez-Bueno F, Marín P, Ríos A, Aguayo JL, Robles R, Piñero A, Fernández JA, Parrilla P (2001) Has the incidence of perforated peptic ulcer decreased over the last decade? (with invited commentary) Dig Surg 18:444–448

    Google Scholar 

  3. Svanes C, Salvesen H, Stangeland L, Svanes K, Soreide O (1993) Perforated peptic ulcer over 56 years: time trends in patients and disease characteristics. Gut 34:1666–1671

    CAS  PubMed  Google Scholar 

  4. Blomgren LG (1997) Perforated peptic ulcer: long-term results after simple closure in the elderly. World J Surg 21:412–414

    CAS  PubMed  Google Scholar 

  5. Bornman PC, Theodorou NA, Jeffery PC, Marks IN, Essel HP, Wright JP, Terblanche J (1990) Simple closure of perforated duodenal ulcer: a prospective evaluation of a conservative management policy. Br J Surg 77:73–75

    CAS  PubMed  Google Scholar 

  6. Siu WT, Leong HT, Li MKW (1997) Single stitch laparoscopic omental patch repair of perforated peptic ulcers. J R Coll Surg Edinb 42:92–94

    CAS  PubMed  Google Scholar 

  7. Alamowic B, Aouad K, Sellam P, Fourmestraux J, Gasne P, Bethoux JP, Boillot JL (2000) Laparoscopic treatment of perforated duodenal ulcer. Gastroenterol Clin Biol 24:1012–1017

    PubMed  Google Scholar 

  8. Arnaud JP, Tuech JJ, Bergamaschi R, Pessaux P, Regenet N (2002) Laparoscopic suture closure of perforated duodenal peptic ulcer. Surg Laparosc Endosc Percutan Tech 12:145–147

    Article  Google Scholar 

  9. Cougard P, Barrat C, Gayral F, Cadiere GB, Meyer C, Fagniez L, Bouillot JL, Boissel P, Samama G, Champault G (2000) Laparoscopic treatment of perforated duodenal ulcers. Results of a retrospective multicentric study. French Society of Laparoscopic Surgery. Ann Chir 125:726–731

    Article  CAS  PubMed  Google Scholar 

  10. Druart ML, Van Hee R, Etienne J, Cadiere GB, Gigot JF, Legrand M, Limbosch JM, Navez B, Tugilimana M, Van Vyve E, Vereecken L, Wibin E, Yvergneaux JP (1997) Laparoscopic repair of perforated duodenal ulcer: a prospective multicenter clinical trial. Surg Endosc 11:1017–1020

    Article  CAS  PubMed  Google Scholar 

  11. Lau WY, Leung KL, Zhu XL, Lam YH, Chung SC, Li AK (1995) Laparoscopic repair of perforated peptic ulcer. Br J Surg 82:814–816

    CAS  PubMed  Google Scholar 

  12. Lau WY, Leung KL, Kwong KH, Davey IC, Robertson C, Dawson JJ (1996) A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture and sutureless technique. Ann Surg 224:131–138

    CAS  PubMed  Google Scholar 

  13. Lee FYJ, Leung KL, Lai PBS, Lau JWY (2001) Selection of patients for laparoscopic repair of perforated peptic ulcer. Br J Surg 88:133–136

    CAS  PubMed  Google Scholar 

  14. Paterson-Brown S (1993) Emergency laparoscopic surgery. Br J Surg 80:279–283

    CAS  PubMed  Google Scholar 

  15. Nathanson LK, Easter DW, Cuschieri A (1990) Laparoscopic repair/toilet of perforated peptic ulcer. Surg Endosc 4:232–233

    CAS  PubMed  Google Scholar 

  16. So JB, Cum CK, Fernandez ML, Goh P (1996) Comparison of laparoscopic and conventional omental patch repair for perforated duodenal ulcer. Surg Endosc 10:1060–1063

    Article  CAS  PubMed  Google Scholar 

  17. Sunderland GT, Chrisholm EM, Lau WY, Chung SSC, Li AKC (1992) Laparoscopic repair of perforated peptic ulcer. Br J Surg 79:785

    CAS  PubMed  Google Scholar 

  18. Crofts TJ, Park KGM, Steel RJC, Chung SSC, Li AKC (1989) A randomized trial of nonoperative treatment for perforated peptic ulcer. N Engl J Med 320:970–973

    CAS  PubMed  Google Scholar 

  19. Costalat G, Dravet F, Noel P, Alquier Y, Vernhet J (1991) Coelioscopic treatment of perforated gastroduodenal ulcer using the ligamentum teres hepatis. Surg Endosc 5:154–155

    CAS  PubMed  Google Scholar 

  20. Pescatore P, Halkic N, Calmes JM, Blum A, Gillet M (1998) Combined laparoscopic–endoscopic method using an omental plug for therapy of gastroduodenal ulcer perforation. Gastrointest Endosc 48:411–414

    CAS  PubMed  Google Scholar 

  21. Darzi A, Cheshire NJ, Somers SS, Super PA, Guillou PJ, Monson JR (1993) Laparoscopic omental patch repair of perforated duodenal ulcer with an automated stapler. Br J Surg 80:1552

    CAS  PubMed  Google Scholar 

  22. Miserez M, Eypasch E, Spangenberger W, Lefering R, Troidl H (1996) Laparoscopic and conventional closure of perforated peptic ulcer. A comparison. Surg Endosc 10:831–836

    Article  CAS  PubMed  Google Scholar 

  23. Naesgard JM, Edwin B, Reiertsen O, Trondsen E, Fearden AE, Rosseland AR (1999) Laparoscopic and open operation in patients with perforated peptic ulcer. Eur J Surg 165:209–214

    PubMed  Google Scholar 

  24. Nassar A (1994) Laparoscopic omental patch repair of perforated duodenal ulcer with automated stapler. Br J Surg 81:1393

    CAS  Google Scholar 

  25. Bergamaschi R, Marvik R, Johnsen G, Thoresen JE, Ystgaard B, Myrvold HE (1999) Open vs laparoscopic repair of perforated peptic ulcer. Surg Endosc 13:679–682

    PubMed  Google Scholar 

  26. Tate JJ, Dawson JW, Lau WY, Li AK (1993) Sutureless laparoscopic treatment of perforated duodenal ulcer. Br J Surg 80:235

    CAS  PubMed  Google Scholar 

  27. Urbano D, Rossi M, De Simone P, Berloco P, Alfani D, Cortesini R (1994) Alternative laparoscopic management of perforated peptic ulcers. Surg Endosc 8:1208–1211

    CAS  PubMed  Google Scholar 

  28. Elio A, Veronese E, Dal Dosso I, Orcalli F (2002) Laparoscopic approach in the treatment of perforated gastroduodenal ulcer. Chir Ital 54:51–53

    PubMed  Google Scholar 

  29. Walsh CJ, Khoo DE, Motson RW (1993) Laparoscopic repair of perforated peptic ulcer. Br J Surg 80:127

    CAS  Google Scholar 

  30. Siu WT, Leong HAT, Law BK, Chau CH, Li AC, Fung KH, Tai YP, Li MK (2002) Laparoscopic repair for perforated peptic ulcer: a randomized controlled trial. Ann Surg 235:313–319

    PubMed  Google Scholar 

  31. Michelet I, Agresta F (2000) Perforated peptic ulcer: laparoscopic approach. Eur J Surg 166:405–408

    CAS  PubMed  Google Scholar 

  32. Wemyss-Holden S, White SA, Robertson G, Lloyd D (2002) Color coding of sutures in laparoscopic perforated duodenal ulcer: a new concept. Surg Laparosc Endosc Percutan Tech 12:177–179

    Article  PubMed  Google Scholar 

  33. Bulut O, Rasmussen C, Fischer A (1996) Acute surgical treatment of complicated peptic ulcers with special reference to the elderly. World J Surg 20:574–577

    CAS  PubMed  Google Scholar 

  34. Katkhouda N, Mavor E, Mason RJ, Campos GM, Soroushyari A, Berne TV (1999) Laparoscopic repair of perforated duodenal ulcers: outcome and efficacy in 30 consecutive patients. Arch Surg 134:845–848

    PubMed  Google Scholar 

  35. Lagoo SA, Pappas TN (2002) Laparoscopic repair for perforated peptic ulcer. Ann Surg 235:320–321

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Jörg Köninger

    Present address: Department of General Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

Authors and Affiliations

  1. Abteilung für Allgemein- und Viszeralchirurgie, Krankenhaus Bietigheim, Riedstrasse 12, 74321, Bietigheim-Bissingen, Germany

    Jörg Köninger, Peter Böttinger, Jens Redecke & Michael Butters

Authors
  1. Jörg Köninger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Böttinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jens Redecke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Butters
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jörg Köninger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Köninger, J., Böttinger, P., Redecke, J. et al. Laparoscopic repair of perforated gastroduodenal ulcer by running suture. Langenbecks Arch Surg 389, 11–16 (2004). https://doi.org/10.1007/s00423-003-0427-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-003-0427-x

Keywords

Search

Navigation