Minimally Invasive Superiority: Laparoscopic Surgery Reduces Complications and Enhances Recovery in Perforated Peptic Ulcer Peritonitis

Background: Perforation peritonitis is a life-threatening surgical emergency having high morbidity and mortality.While open surgery has been the standard treatment, laparoscopic repair offers potential benefits, including faster recovery and fewer complications.Method: This prospective, randomised, comparative study compared outcomes between laparoscopic (n = 25) and open (n = 25) surgical repair in 50 patients with perforated peritonitis.The inclusion criteria were hemodynamic stability, a confirmed diagnosis of perforation, and the absence of diffuse fecal peritonitis.Outcomes assessed included operative time, postoperative pain, ICU stay, recovery of bowel function, hospital stay, return to daily activities, and complication rates.Results: It showed that laparoscopic repair had significant advantages: shorter operative time (91.8018.59 vs. 128.4431.13min, p<0.001), lower postoperative pain (2.840.69 vs. 6.361.04,p<0.001), reduced ICU stay (1.960.79 vs. 4.721.40days, p<0.001), faster bowel recovery (1.920.95 vs. 4.481.33days, p<0.001), and shorter hospital stay (5.441.26 vs. 11.802.63days, p<0.001).Patients undergoing laparoscopy resumed daily activities earlier (12.202.18 vs. 21.924.11days, p<0.001).Importantly, laparoscopy significantly reduced surgical site infections (8.0% vs. 84.0%,p<0.001) and pulmonary complications (32.0% vs. 76.0%,p=0.002).Conclusion: Laparoscopic repair is superior to open surgery for perforation peritonitis, offering shorter operative times, less pain, quicker recovery, and fewer complications.These findings support laparoscopy as the preferred approach for hemodynamically stable patients.