Abstract:
Laparoscopy is an important milestone in the history of surgery. Almost all abdominal surgeries can now be approached laparoscopically. Laparoscopic perforated duodenal ulcer(DU) repair has been shown to be feasible . However, whether its superior to open repair is yet to be established and has not become the standard of care . Laparoscopy offers better visualisation and early recovery.
KEY WORDS: LAPAROSCOPIC APPROACH, PERFORATED PEPTIC ULCER
Introduction:
Laparoscopy is an important milestone in the history of surgery. Almost all abdominal surgeries can now be approached laparoscopically. Laparoscopic perforated duodenal ulcer(DU) repair has been shown to be feasible(1) . However, whether its superior to open repair is yet to be established and has not become the standard of care . Laparoscopy offers better visualisation and early recovery. Perforated duodenal ulcer is a surgical emergency. In
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Special attention was given to the supra- and subhepatic regions, the left subdiaphragmatic space. After lavage, all the fluid was aspirated and a tube drain was kept in the subhepatic space. In case of generalized peritonitis, a second drain was placed in the pelvis. Posoperatively, proton pump inhibitor, intravenous fluids, and broad- spectrum antibiotics were administered.
During surgery, biopsy was taken from the edge of the ulcer to test for the presence of helicobacter pylori. H. pylori infection was diagnosed by histology. If it was positive, a triple therapy regimen consisting of amoxicillin,pantoprazole and metronidazole for one week was administered on resumption of oral intake. Patient taking non-steroidal anti-inflamatery drugs were adiveed to stop these drugs. Patient were called for follow up at 1 week, 1 month, 6 months, 12months and yearly thereafter. They were subjected to upper gastrointestinal endoscopy at 1 month and 6 months and at yearly intervals