Management of early hollow viscus perforation: laparoscopic repair in contrast to laparotomy repair

Background: Acute abdomen refers to severe abdominal pain that occurs suddenly. This study was conducted to compare open versus laparoscopic repair for the treatment of early hollow viscus perforation. Methods: The study involved 50 patients of both genders, divided into two groups. Group I underwent laparoscopic repair, while group II underwent open repair. Variables such as the time taken for resumption of daily activities and operative time were recorded for all patients. Study was done in Kamineni institute of medical sciences, Narketpally Nalgonda (d.t) Telangana prospective observational study for a period from March 2023 to April 2024. Results: Abdominal distension occurred before pain in 7 patients in group I and 6 patients in group II, after pain in 4 patients in group I and 3 patients in group II, and with pain in 14 patients in group I and 16 patients in group II. Bilious vomiting was observed in 12 patients in group I and 11 patients in group II, while no vomiting occurred in 13 patients in group I and 14 patients in group II. Gastric perforation was diagnosed in 5 patients in group I and 5 patients in group II, ileal perforation in 2 patients in group I and 3 patients in group II, and duodenal perforation in 18 patients in group I and 17 patients in group II. The difference was significant (p<0.05). Conclusions: This study compared laparoscopic and open repair for hollow viscus perforation in 50 patients. Both groups had similar demographics and initial clinical characteristics. The laparoscopic group experienced significantly shorter surgical times (102.08 vs. 133.52 minutes, p<0.0001), shorter hospital stays (most discharged within 7-14 days vs. 14-21 days), and quicker resumption of daily activities (9.32 vs. 13.68 days, p=0.0042). These findings suggest that laparoscopic repair offers advantages in terms of faster recovery and reduced hospital stays compared to open repair, making it a preferable option for managing hollow viscus perforations.