425 A Retrospective Comparison of Laparoscopic and Open Approaches in the Management of Perforated Peptic Ulcer Disease

Abstract Aim To compare the outcomes of laparoscopic and open surgical repair of duodenal and gastric ulcer perforation in terms of morbidity and mortality. Method A retrospective analysis was conducted of all patients who underwent emergency repair of duodenal (DU) and gastric ulcer (GU) perforation between 2019 and 2025 at Calderdale and Huddersfield NHS Foundation Trust. Patients were divided into laparoscopic (n=34) and open repair (n=19) groups. Data were collected from electronic patient records/Bluespier, including demographics, ASA grade, ulcer location, operative time, ICU admission, hospital stay, complications, and mortality. Statistical analysis was performed using SPSS. Results Fifty-three patients underwent emergency surgery (31 males, 22 females), aged 25–87 years (mean 59.36 ± 15.66). Mean operative time was 98.4 minutes for laparoscopic and 112.3 minutes for open repair (P=0.04). ICU admission was higher in the open group (63.2% vs 35.3%, P=0.0002), with mean ICU stays of 5.6 vs 3 days (P=0.02). Mean hospital stay was 16.1 days (open) vs 14.6 days (laparoscopic). Repair site leaks were more frequent in the laparoscopic group (20.6% vs 0%), but overall complications were significantly lower (P=0.002). Thirty-day mortality was lower in the laparoscopic group (5.9% vs 21.1%, P=0.04). Conclusions Laparoscopic repair for duodenal perforation is associated with reduced mortality, fewer ICU admissions, and shorter hospitalization compared to open repair. These results suggest laparoscopic surgery is a viable and effective option for a selective group of patients.