A COMPARATIVE STUDY OF LAPAROSCOPIC VERSUS OPEN APPROACH FOR THE SURGICAL TREATMENT OF PERFORATED DUODENAL ULCER

Background: Perforated duodenal ulcer disease is a surgical emergency that has undergone significant changes in its management over recent decades. The identification of Helicobacter pylori and its link to the development of peptic ulcers, the introduction of proton pump inhibitors, and the application of laparoscopy in conjunction with endoscopy have all significantly influenced new management strategies for peptic ulcer disease. However, despite these advancements, the frequency of ulcer perforations requiring surgery has not decreased as dramatically as the worldwide incidence of peptic ulcer disease has; thus, emergency surgery remains a common practice for addressing complications associated with peptic ulcer disease. Aim: To compare the outcomes of patients who underwent laparoscopic and open repair for perforated duodenal ulcers regarding operative and postoperative factors. Patients and Methods: A prospective observational study was carried out in Al- Sader teaching hospital and Al-Saadi private hospital in Basrah from February 2020 to April 2023 to compare the outcomes of patients who underwent laparoscopic and open repair for perforated duodenal ulcers regarding operative and post-operative factors, a total of 43 patients (27 males/ 16 females) with age range of (31-66) years divided into two groups, open method group (24 cases) and laparoscopic method group(19 cases) were included in the study. The statistical analysis was done using SPSS spreadsheet version 26, and the level of statistical significance was set to 0.05. Results: This comparative study showed significantly shorter operation time in the laparoscopy group with less post-operative pain and shorter hospital stay. Postoperative complications, like as wound infections and incisional hernias, were much reduced in the laparoscopic group; however, there was no notable difference in respiratory infections. Conclusion: Laparoscopic repair of perforated duodenal ulcers is both safe and effective compared to open repair, offering benefits like reduced operative time, fewer wound-related complications, and quicker recovery and return to everyday activities.