Research Article
Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?
| | Variable | Laparoscopy n = 49 (29%) | Laparotomy n = 120 (71%) | Total n = 169 (100%) | value |
| | Sex | | | | 0.009 | | Male | 43 (87.8%) | 82 (68.3%) | 125 (74%) | | | Female | 6 (12.2%) | 38 (31.7%) | 44 (26%) | | | Age (years, median, and range) | 48 (21–81) | 53 (21–97) | 52 (21–97) | 0.002 | | Comorbidities | 25 (51%) | 72 (60%) | 97 (57.4%) | 0.284 | | Sepsis criteria | 6 (12.2%) | 46 (38.3%) | 52 (30.8%) | 0.001 |
| | Sepsis group | | | | 0.003 | | Nonsepsis | 43 (87.8%) | 74 (61.7%) | 117 (69.2%) | | | Sepsis | 5 (10.2%) | 28 (23.3%) | 33 (19.5%) | | | Septic shock | 1 (2%) | 18 (15.0%) | 19 (11.2%) | |
| | Boey score | | | | 0.317 | | 0 | 22 (44.9%) | 43 (35.8%) | 65 (38.5%) | | | 1 | 17 (34.7%) | 35 (29.2%) | 52 (30.8%) | | | 2 | 7 (14.3%) | 28 (23.3%) | 35 (20.7%) | | | 3 | 3 (6.1%) | 14 (11.7%) | 17 (10.1%) | |
| | Categorical Boey score | | | | 0.062 | | Boey score <2 | 39 (79.6%) | 78 (65%) | 117 (69.2%) | | | Boey score ≥2 | 10 (20.4%) | 42 (35%) | 52 (30.8%) | |
| | Symptoms-surgery delay (hours) | | | | 0.700 | | <12 | 19 (38.8%) | 41 (34.2%) | 60 (35.5%) | | | 12 < 24 | 13 (26.5%) | 29 (24.2%) | 42 (24.9%) | | | >24 | 17 (34.7%) | 50 (41.7%) | 67 (39.6%) | |
| | Ulcer localization | | | | 0.305 | | Gastric | 22 (44.9%) | 58 (48.3%) | 80 (47.3%) | | | Pyloric | 16 (32.7%) | 47 (39.2%) | 63 (37.3%) | | | Duodenal | 11 (22.4%) | 14 (11.7%) | 25 (14.8%) | | | Gastrojejunal anastomosis | 0 (0%) | 1 (0.8%) | 1 (0.6%) | |
| | Procedure | | | | 0.323 | | Suture (nonresection procedure) | 49 (100%) | 115 (95.8%) | 164 (97%) | | | Resection procedure | 0 (0%) | 5 (4.2%) | 5 (3%) | |
| | Biopsy (only gastric location) | | | | <0.001 | | Yes | 8 (36.4%) | 48 (82.8%) | 56 (70%) | | | No | 14 (63.6%) | 6 (10.3%) | 20 (25%) | | | Not applied | 0 (0%) | 4 (6.9%) | 4 (5%) | | | Operative time (minutes, median, and range) | 100 (40–188) | 80 (40–260) | 90 (40–260) | 0.01 | | Early complications (<30 days) | 9 (18.4%) | 50 (41.7%) | 59 (34.9%) | 0.004 |
| | Complications (Clavien-Dindo) | | | | 0.032 | | Grade I | 0 (0%) | 1 (2%) | 1 (1.7%) | | | Grade II | 3 (33.3%) | 12 (24%) | 15 (25.4%) | | | Grade III | 5 (55.6%) | 7 (14%) | 12 (20.3%) | | | Grade IV | 0 (0%) | 13 (26%) | 13 (22%) | | | Grade V | 1 (11.1%) | 17 (34%) | 18 (30.5%) | | | Mortality | 1 (2.0%) | 17 (14.2%) | 18 (10.7%) | 0.02 | | Suture dehiscence | 2 (4.1%) | 5 (4.2%) | 7 (4.1%) | 0.980 | | Reoperation | 3 (6.1%) | 13 (10.8%) | 16 (9.5%) | 0.343 | | Late complications (>30 days) | 5 (10.4%) | 15 (16%) | 20 (14.1%) | 0.369 | | Hospital stay (days, median, and range) | 6 (4–79) | 7 (1–152) | 7 (1–152) | 0.001 | | Oral intake (days, median, and range) | 3 (1–7) | 4 (2–42) | 3.50 (1–52) | 0.021 |
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