Outcome After Laparoscopic Surgery for Peptic Ulcer Perforation

Sponsor

Chang Wei-Jung (Other)

Overall Status

Completed

CT.gov ID

NCT05147870

Collaborator

(none)

150

Enrollment

104

Actual Duration (Months)

Study Details

Study Description

Brief Summary

Despite advances in laparoscopic surgery for perforated peptic ulcer (PPU), intra-abdominal abscess (IAA) is recognized as one of the commonly reported complications with relation to the extent of infectious abdominal contamination. Herein, the investigators report their experience of laparoscopic surgery for PPU with/without peritoneal irrigation and discuss postoperative outcome. The investigators retrospectively examined the electronic medical records of the patients who underwent laparoscopic surgery for perforated peptic ulcer at a single medical center in Taiwan between January 2013 and August 2021. Retrospectively, the investigators would include those patients with clinical diagnosis of PPU who underwent emergent laparoscopic surgery. The patients with previous abdominal surgery, pathologic confirmed malignant ulcer perforation or concomitant ulcer bleeding were excluded. The investigators focused on post-operative complications and outcome after laparoscopic surgery with or without peritoneal irrigation. This information can be important in improving surgical options with respect to risk and potential benefits in this setting.

Condition or Disease	Intervention/Treatment	Phase
Intraabdominal Abscess After Procedure Leakage Pneumonia Operation Wound; Infection	Procedure: Peritoneal irrigation Procedure: Suction only

Study Design

Study Type:

Observational

Actual Enrollment :

150 participants

Observational Model:

Cohort

Time Perspective:

Retrospective

Official Title:

Whether Peritoneal Irrigation Intra-operatively Effects on the Outcome After Laparoscopic Surgery for Peptic Ulcer Perforation

Actual Study Start Date :

Jan 1, 2013

Actual Primary Completion Date :

Aug 31, 2021

Actual Study Completion Date :

Aug 31, 2021

Arms and Interventions

Arm	Intervention/Treatment
Irrigation group	Procedure: Peritoneal irrigation For patients allocated to the irrigation group, peritoneal lavage was performed at the surgeon's discretion based on surgical findings and preference.
Suction only group	Procedure: Suction only In the suction only group, one surgical gauze each was placed in the splenophrenic space and Morison's pouch to soak up any remaining purulent fluid followed by turning the patient into the Trendelenburg position for inspection of the lower abdominal cavity. Any interloop adhesions were carefully divided and the gauze-wiping maneuver was used to soak up the residual peritoneal fluid, and all bowel loops were investigated to the root of the mesentery.

Arm

Intervention/Treatment

Irrigation group

Procedure: Peritoneal irrigation

For patients allocated to the irrigation group, peritoneal lavage was performed at the surgeon's discretion based on surgical findings and preference.

Suction only group

Procedure: Suction only

In the suction only group, one surgical gauze each was placed in the splenophrenic space and Morison's pouch to soak up any remaining purulent fluid followed by turning the patient into the Trendelenburg position for inspection of the lower abdominal cavity. Any interloop adhesions were carefully divided and the gauze-wiping maneuver was used to soak up the residual peritoneal fluid, and all bowel loops were investigated to the root of the mesentery.

Outcome Measures

Primary Outcome Measures

Short-term outcome with wound infection, pneumonia, leakage, and intraabdominal abscess [Through hospitalization, an average of 8 days]
Complication grading used clavien dindo classification