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A comparative study on laparoscopic and open surgical approaches for perforated peptic ulcer repair: efficacy and outcomes analysis

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Abstract

Purpose

This study aimed to compare the clinical outcomes of the clinical outcomes of laparoscopic and open sutures for peptic ulcer perforation (PPU).

Materials and methods

PubMed, EMBASE, and Cochrane Library databases were searched for eligible studies from inception to March 31, 2023. Odds ratios (OR) and 95% confidence intervals (Cl) were also calculated. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of the included studies. This study was performed using the Stata (V.16.0) software.

Results

A total of 29 studies involving 17,228 patients were included in this study. In terms of postoperative outcomes, the laparoscopic group had a shorter postoperative hospital stay (MD = -0.29, 95%CI = -0.44 to -0.13, P = 0.00), less blood loss (MD = -0.45, 95%CI = -0.82 to -0.08, P = 0.02), fewer wound infection (OR = 0.20, 95%CI = 0.17 to 0.24, P = 0.00), fewer pneumonia (OR = 0.59, 95%CI = 0.41 to 0.87, P = 0.01), fewer respiratory complications (OR = 0.26, 95%CI = 0.13 to 0.55, P = 0.00) and lower postoperative morbidity (OR = 0.51, 95%CI = 0.33 to 0.78, P = 0.00). The laparoscopic group had a lower mortality rate (OR = 0.36, 95%CI = 0.27 to 0.49, P = 0.00) than the open group. We also found that the laparoscopic group had a higher overall complication rate than the open group (OR = 0.45, 95%CI = 0.34 to 0.60, P = 0.00).

Conclusion

Laparoscopic repair was associated with a lower risk of mortality than open repair in patients with PPU. Laparoscopic repair may be a better option in patients with PPU.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Acknowledgements

We acknowledge all authors whose publications are referred to in our article.

Funding

This study was supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine (W0190).

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Author notes

  1. Zi-Wei Li and Yue Tong contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Zi-Wei Li, Yue Tong, Fei Liu, Xu-Rui Liu, Quan Lv, Kai-Lin Tang, Lian-Shuo Li, Xiao-Yu Liu, Wei Zhang & Dong Peng

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  1. Zi-Wei Li
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Contributions

Data extraction, Zi-Wei Li, Yue Tong, Quan Lv, Xiao-Yu Liu and Kai-Lin Tang; quality assessments, Fei Liu; data analysis, Xu-Rui Liu, Lian-Shuo Li and Wei Zhang; writing-origin draft, Zi-Wei Li; writing-review and editing, Dong Peng, Zi-Wei Li, Kai-Lin Tang, Fei Liu, Xu-Rui Liu, and Wei Zhang. All authors have read and approved the final manuscript. All authors have agreed on the manuscript that will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

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Correspondence to Dong Peng.

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Li, ZW., Tong, Y., Liu, F. et al. A comparative study on laparoscopic and open surgical approaches for perforated peptic ulcer repair: efficacy and outcomes analysis. Langenbecks Arch Surg 408, 435 (2023). https://doi.org/10.1007/s00423-023-03171-1

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