Ricerc@Sapienza

Background:
The incidence of perforated peptic ulcers has decreased during the last decades but
the optimal treatment for these patients remains controversial. At the same time, a
laparoscopic approach to this condition has been adopted by an increased number of
surgeons.
Therefore, this study wants to evaluate the postoperative results of the laparoscopic
treatment of perforated peptic ulcer performed in one Italian center with extensive
experience in laparoscopic surgery.
Methods:
This retrospective study includes 94 patients who were operated for perforated peptic
ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of
Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for
demographics, surgical procedure, complications, and short-term outcomes.
Results:
The diagnosis was made clinically and confi rmed by the presence of gas under
diaphragm on abdominal X-ray. All patients underwent primary suture repair with or
without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in
28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean
of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative
complications occurred in 19 (20%) patients and 18 (19%) patients died.
Conclusions:
Perforated peptic ulcer is a severe condition that requires early hospital admission and
immediate surgery. Laparoscopy in experienced centers and for selected patients is safe,
associated with optimal outcomes and should be the preferred approach.