Acid peptic perforation of the duodenum remains a surgical challenge.
In this study, doctors evaluated a combination of endoscopy and laparoscopy for the management of early duodenal perforation.
The team included 42 patients with early (<12hrs) perforation.
Patients were managed by laparoscopic plication and lavage. Endoscopy was used to identify the site of perforation and guide the repair in 35 patients.
All patients received Helicobacter pylori treatment.
|All patients received Helicobacter pylori treatment.|
|Journal of the American College of Surgeons|
They were examined by endoscopy at 3 months.
The doctors compared the patients with 40 controls who underwent open procedures for duodenal perforation.
The team determined that endoscopic/laparoscopic management was effective, and that it compared favorably with open procedures with regard to surgical time and complications.
In addition, they found that endoscopic snaring of omentum and pulling into the defect was an effective adjunct for plication.
Dr Igor Malkov's team concluded, "Endoscopic/laparoscopic repair of perforated duodenal ulcers is a safe and effective surgical tactic if followed by treatment for H. pylori".