Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: A SWSC multicenter study

Adel Alhaj Saleh, Esteban C. Esquivel, John T. Lung, Barbara C. Eaton, Brandon R. Bruns, Galinos Barmparas, Daniel R. Margulies, Alexander Raines, Cressilee Bryant, Christopher E. Crane, Elizabeth P. Scherer, Thomas J. Schroeppel, Eliza Moskowitz, Justin Regner, Richard Frazee, Eric M. Campion, Matthew Bartley, Jared Mortus, Jeremy Ward, Mhd Hasan AlmekdashSharmila Dissanaike

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

RCTs showed benefits in Lap repair of perforated peptic ulcer (PPU). The SWSC Multi-Center Trials Group sought to evaluate whether Lap omental patch repairs compared to Open improved outcomes in PPU in general practice. Data was collected from 9 SWSC Trial Group centers. Demographics, operative time, 30-day complications, length of stay and mortality were included. 461 patients: Open in 311(67%) patients, Lap in 132(28%) with 20(5%) patients converted from Lap to Open. Groups were similar at baseline. Significant variability was found between centers in their utilization of Lap (0–67%). Complications at 30 days were lower in Lap (18.5% vs. 27.5%, p < 0.05) as was unplanned re-operation (4.7% vs 14%, p < 0.05). Lap reduced LOS (6 vs 8 days, p < 0.001). Ileus was more in Lap (42% vs 18 p < 0.001) operative time was 14 min higher in Lap(p < 0.01) and admission to OR time was 4 h higher in Lap(<0.05). No significant difference readmission or mortality. Our results suggest Lap should be considered a first-line option in suitable PPU patients requiring omental patch repair in centers that have the capacity and resources 24/7.

Original languageEnglish (US)
Pages (from-to)1060-1064
Number of pages5
JournalAmerican journal of surgery
Volume218
Issue number6
DOIs
StatePublished - Dec 2019

ASJC Scopus subject areas

  • Surgery

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