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Laparoscopic omental patch repair of perforated peptic ulcers Atsushi NAGASHIMA 1 , Masakazu DOI 1 , Shinobu HAYASHI 1 , Tomohisa EGAWA 1 , Yasuhiro ITOH 1 , Mitsuhide KITANO 1 , Masayuki SHIMIZU 1 , Hiroshi YOSHII 1 1Department of Surgery, Saiseikai Kanagawaken Hospital Keyword: 穿孔性胃・十二指腸潰瘍 , 腹腔鏡下手術 , 大網被覆術 pp.153-158
Published Date 2007/4/15
DOI https://doi.org/10.11477/mf.4426100032
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 Laparoscopic closure of perforated peptic ulcer was performed in ninety three patients between 1992 and 2006. The indications for laparoscopic surgery of perforated duodenal ulcer were relatively good general condition, no severe underlying disease, no duodenal and within 24 hours of perforation. The indication for perforated gastric ulcer was small perforation of the anterior wall of the stomach. Before laparoscopic treatment, endoscopy was performed to diagnose the peptic ulcer and confirm the absence of stenosis. Simple closure with an omental patch was performed by laparoscopic interrupted suture. An extracorporeal Roeder knot was tied in the suture and pushed down to fix the patch of omentum over the perforation. Peritoneal irrigation was carried out with 3-5 liters of saline. The mean operating time was 89.5 minutes. A nasogastric tube was maintained for 1 day after operation, and proton pump inhibiter was administered. The patients could resume oral ingestion of food 3 days after surgery. Postoperative course was uneventful in 90 cases(96.8%). The mean hospital stay was 9.5 days. We concluded that laparoscopic omental patch repair should be considered as standard therapy for perforated peptic ulcers.


Copyright © 2007, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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