Diagnosis and treatment of latent perforation of peptic ulcer during laparoscopic cholecystectomy
- VernacularTitle:腹腔镜胆囊切除术中隐匿性胃十二指肠溃疡穿孔的诊断与处理
- Author:
Shilin ZHAN
;
Jianxiong CHEN
;
Shaoping WANG
- Publication Type:Journal Article
- Keywords:
Laparoscopic cholecystectomy;
Peptic ulcer;
Latent perforation
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of latent perforation of peptic ulcer (LPPU) during laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 13 cases of LPPU diagnosed during LC from January 1994 to November 2005. Results All the 13 cases were misdiagnosed before the LC and clarified as having LPPU during the LC. Three cases of anterior duodenal bulbar perforation (0.4~0.5 cm in size) were laparoscopically repaired, whereas conversions to open repair were performed in 5 cases of duodenal perforation (0.5~1 cm in size) and 5 cases of gastric perforation (0.6~1 cm in size) because of severe adhesion or difficult performance. No surgical complications occurred. Twelve cases were followed for 6~36 months (mean, 27 months). The symptoms disappeared and gastroscopy showed healed ulcer. No recurrence of perforation was found. Conclusions Underestimation of LPPU leads to misdiagnosis, and preoperative gastrosopy can prevent it. For small perforation, laparoscopic repair and abdominal drainage can be employed. But in most cases, a conversion to open surgery is required. It is necessary to give regular internal medicine for peptic ulcer after operation.
