Immediate Versus Delayed Surgery Following Resuscitation in Perforation Peritonitis: A Meta-Analysis of Studies from India

Perforation peritonitis represents one of the most common abdominal emergencies in India, often caused by peptic ulcers, typhoid, tuberculosis, or traumatic events \[1]. Surgical intervention is the cornerstone of management, yet the timing of surgery remains a point of clinical debate. Traditional teaching advocates immediate surgery to control contamination; however, recent literature suggests that brief resuscitation to optimize physiological status may improve outcomes \[2,3]. In India, where patients often present late and in sepsis or shock, the decision between immediate surgery and delayed surgery following initial stabilization can have significant implications on morbidity and mortality \[4]. This meta-analysis synthesizes Indian clinical studies to compare outcomes between immediate and delayed surgery after resuscitation in patients with perforation peritonitis.