The Assessment of the Perioperative Outcome of Laparoscopic versus Open Management of Gastroduodenal Perforation. Our Two-Center Comparative Experience.

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Background and Aim: to compare the early outcome results of laparoscopic versus open management as laparoscopic management seems to have multiple attractions for surgeons with marked controversy.Materials and Methods: All patients of Gastroduodenal perforation were included and randomized for laparoscopic or open repair.The data obtained from the diagnostic flowchart, operative details, postoperative morbidities, and mortalities were collected for statistical analysis.Results: sixty-six patients were assigned to the group laparoscopic cases and 74 candidates to the open one.The rate of conversion was 45.5% (n=30/66).The finished laparoscopy group had a noticeably longer operating time, less postoperative discomfort, a lower rate of wound infection, and a shorter hospital stay than the open group.Additionally, there was a decreased incidence of pulmonary problems, wound dehiscence, leakage, ileus, intraabdominal collection, and other complications in the laparoscopic group, and re-intervention than in the open group.The risk factors for conversion included age, preoperative shock, a high Boey score, a high Mannheim peritonitis index, and co-morbidities.However, by multivariate analysis, only preoperative shock and old age were predictors of conversion.Conclusion: In individuals with low surgical risk, laparoscopic repair is as possible and secure as compared to open repair (Boey score 0 and 1).Laparoscopic repair has multiple advantages in comparison with open repair.Clinical significance: laparoscopic repair of a perforated peptic ulcer has many benefits in comparison with the open repair; (lower postoperative pain, lower incidence of postoperative morbidities, better cosmetic outcome, earlier recovery, and shorter hospital stay).

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