Manejo laparoscópico de las úlceras pépticas perforadas

Objective: To inform the results obtained by the mini-invasive approach in the treatment of perforated peptic ulcers. Material and methods: Prospective, multicentric, longitudinal, observational and noncomparative study. One took place between May of 1993 to May of the 2004, when the authors made 13 repairs laparoscopics of perforations of peptic ulcers. In all, the patients analyzed the following variables: age, sex, antecedents of ulcerous, antecedent disease of recent ingestion of AINES, anatomical site of the perforated, technical peptic ulcer surgical, surgical time, histological study, morbidity and mortality. Results: Thirteen patients were evaluated, 2 were male and 11 female. The average age was 50 (range between 30 and 74). Diagnosis was performed clinically and confirmed by laparoscopy in all cases. Seven patients (54%) had a history of peptic ulcer disease, 6 patients (46%) reported recent ingestion of NSAID’s. Of the 13 patients, 7 presented with duodenal ulcer, 3 prepiloric and 3 gastric. The average surgical time was 40 minutes (range between 30 and 120 minutes). Surgery consisted of surgical lavage of the abdominal cavity and primary closure with Polybutester (novafil) and omental patch in all patients. All of the endoscopic biopsies were positive for H. pylori. There was no morbidity or mortality. Conclusion: Laparoscopic treatment of gastroduodenal perforation is safe and effective.