腹腔镜修复消化性溃疡穿孔-我们的初步经验

Md. Saiful Hoque, Gazi Md. Zakir Hossain, Nur Hossain Bhuiyan, Md. Rashedul Hasan, Mayin Uddin Mahmud, Alamgir Rashid Chowdhury
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摘要

背景:腹腔镜下修复穿孔性消化性溃疡早在1990年就有报道,但尚未被广泛接受。本研究的目的是评估腹腔镜修复在常规临床实践中的安全性和有效性。方法:这是对2009年7月至2010年6月间接受腹腔镜修复穿孔性消化性溃疡的30例患者的前瞻性分析。结果:30例患者经临床检查及腹部x线片诊断为穿孔性溃疡,经腹腔镜确认,平均年龄45岁(25 ~ 52岁)。十二指肠溃疡穿孔28例,胃溃疡穿孔2例。其中2例为DU穿孔,1例为胃溃疡穿孔,3例需转开腹。平均手术时间75分钟(75-150分钟)。术后平均住院时间6(5-10)天。术后恢复良好。无手术相关并发症,但1例患者因延迟恢复需要转至ICU,最终恢复良好。1例患者术后发生渗漏,经剖腹手术治疗。3例转换病例中有1例出现伤口感染,但腹腔镜病例中与伤口相关的并发症非常少。结论:腹腔镜修复是一种安全、有效的消化性溃疡穿孔修复方法。DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19535
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Laparoscopic Repair of Peptic Ulcer Perforation - Our Initial Experience
Background: Laparoscopic repair of perforated peptic ulcer was reported in 1990 but has not gained wide acceptance. The aim of this study was to evaluate the safety and efficacy of laparoscopic repair in routine clinical practice. Methods: This was a prospective analysis of 30 patients who underwent laparoscopic repair of a perforated peptic ulcer between July 2009 and June2010. Results: Thirty patients of mean age 45 (range 25-52) years had perforated ulcer diagnosed by clinical examination and x-ray abdomen and confirmed by laparoscopy. 28 was duodenal ulcer perforation and rest 2 was gastric ulcer perforation. Only 3 patients required conversion to laparotomy out of them 2 were DU perforation and one was gastric ulcer perforation. Mean operation time was 75 (range 75-150) minutes. Mean postoperative hospital stay was 6 (5-10) days. Postoperative convalescences were good. There was no operation related complication but one patient needs transfer to ICU for delayed recovery and the patient eventually recovered well. Post-operative leakage occurred in one patient and that was treated by laparotomy. One of 3 conversion cases developed wound infection but wound related complications in laparoscopic cases were very negligibe. Conclusion: Laparoscopic repair is a safe and effective procedure for repair of perforated peptic ulcer. DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19535
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