Log in

No Abdominal Drainage After Single-Port Laparoscopic Repair for Perforated Duodenal Ulcers

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Nowadays, closure of the perforation with or without omental patch is the main surgical approach for most perforated duodenal ulcer. There have been limited high-quality studies to clarify the role of drainage after perforated duodenal ulcer laparoscopic repair. We performed this study to evaluate the role of abdominal drainage after simple closure for the treatment of low-risk perforated duodenal ulcer. A consecutive case series was conducted including patients with size of duodenal perforation no more than 5 mm who underwent single-port laparoscopic simple repair at Hue University of Medicine and Pharmacy Hospital from January 2012 to June 2018. In this study, sixty-five executive perforated duodenal ulcer patients with the size of the perforation no more than 5 mm, an ASA score equal or less than 3, and a Boey score of 0 or 1 were treated by single-port laparoscopic simple repair. All patients (100%) had a perforation of the anterior side of duodenum. The mean size of the perforations was 3.4 mm. We did not use abdominal drainage after single-port laparoscopic simple closure without omentoplasty. There were no documented leakage of the repair site and no residual abscess postoperatively. The mean analgesic use duration was 2.8 ± 0.8 days. The mean hospital stay duration was 5.6 ± 0.8 days. At 30-day follow-up, one patient (1.5%) had wound infection. No port-site hernia was found and there was no mortality. For small-size and low-risk perforated duodenal ulcer, no-drainage after single-port laparoscopic simple repair is safe and effective. The patients without abdominal drainage require less analgesic use and have short hospital stay.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA (2015) Perforated peptic ulcer. Lancet 386(10000):1288–1298. https://doi.org/10.1016/S0140-6736(15)00276-7

    Article  PubMed  PubMed Central  Google Scholar 

  2. Okumura K, Hida K, Kunisawa S, Nishigori T, Hosogi H, Sakai Y, Imanaka Y (2018) Impact of drain insertion after perforated peptic ulcer repair in a Japanese nationwide database Analysis. World J Surg 42(3):758–765. https://doi.org/10.1007/s00268-017-4211-4

    Article  CAS  PubMed  Google Scholar 

  3. Byrge N, Barton RG, Enniss TM, Nirula R (2013) Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis. Am J Surg 206(6):957–963. https://doi.org/10.1016/j.amjsurg.2013.08.014

    Article  PubMed  Google Scholar 

  4. Lui FY, Davis KA (2010) Gastroduodenal perforation: maximal or minimal intervention? Scand J Surg 99(2):73–77. https://doi.org/10.1177/145749691009900205

    Article  CAS  PubMed  Google Scholar 

  5. Levy M (1984) Intraperitoneal drainage. Am J Surg 147(3):309–314. https://doi.org/10.1016/0002-9610(84)90156-9

    Article  CAS  PubMed  Google Scholar 

  6. Petrowsky H, Demartines N, Rousson V, Clavien PA (2004) Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg 240(6):1074–1085. https://doi.org/10.1097/01.sla.0000146149.17411.c5

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schein M (2008) To drain or not to drain? The role of drainage in the contaminated and infected abdomen: an international and personal perspective. World J Surg 32(2):312–321. https://doi.org/10.1007/s00268-007-9277-y

    Article  PubMed  Google Scholar 

  8. Pai D, Sharma A, Kanungo R, Jagdish S, Gupta A (1999) Role of abdominal drains in perforated duodenal ulcer patients: a prospective controlled study. Aust N Z J Sur 69(3):210–213. https://doi.org/10.1046/j.1440-1622.1999.01524.x

    Article  CAS  Google Scholar 

  9. Khan S, Rai P, Misra G (2015) Is prophylactic drainage of peritoneal cavity after gut surgery necessary?: A non-randomized comparative study from a teaching hospital. J Clin Diagn Res 9(10):PC01–PPC3. https://doi.org/10.7860/JCDR/2015/8293.6577

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wallace C (1912) Abdominal drainage in the treatment of peritonitis. Lancet 179(4633):1603–1604

    Article  Google Scholar 

  11. Bertleff MJ, Lange JF (2010) Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 27(3):161–169. https://doi.org/10.1159/000264653

    Article  PubMed  Google Scholar 

  12. Ansari MM, Akhtar A, Haleem S, Husain M, Kumar A (2012) Is there a role of abdominal drainage in primarily repaired perforated peptic ulcers ? J Exp Integr Med 2(1):47–54. https://doi.org/10.5455/jeim.201111.or.015

    Article  Google Scholar 

  13. Wu X, Tian W, Kubilay NZ, Ren J, Li J (2016) Is it necessary to place prophylactically an abdominal drain to prevent surgical site infection in abdominal operations? A Systematic Meta-Review. Surg Infect 17(6):730–738. https://doi.org/10.1089/sur.2016.082

    Article  Google Scholar 

  14. Vărcuş F, Beuran M, Lica I, Turculet C, Cotarlet AV, Georgescu S, Vintila D, Sabău D, Sabau A, Ciuce C, Bintintan V, Georgescu E, Popescu R, Tarta C, Surlin V (2017) Laparoscopic repair for perforated peptic ulcer: a retrospective study. World J Surg 41(4):948–953. https://doi.org/10.1007/s00268-016-3821-6

    Article  PubMed  Google Scholar 

  15. Ates M, Sevil S, Bakircioglu E, Colak C (2007) Laparoscopic repair of peptic ulcer perforation without omental patch versus conventional open repair. J Laparoendosc Adv Surg Tech A 17(5):615–619. https://doi.org/10.1089/lap.2006.0195

    Article  PubMed  Google Scholar 

  16. Kim JH, Chin HM, Bae YJ, Jun KH (2015) Risk factors associated with conversion of laparoscopic simple closure in perforated duodenal ulcer. Int J Surg 15:40–44. https://doi.org/10.1016/j.ijsu.2015.01.028

    Article  PubMed  Google Scholar 

  17. Lee J, Sung K, Lee D, Lee W, Kim W (2011) Single-port laparoscopic repair of a perforated duodenal ulcer: intracorporeal “cross and twine” knotting. Surg Endosc 25(1):229–233. https://doi.org/10.1007/s00464-010-1164-1

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to express their sincere gratitude to the patients of this work. We also wish to thank doctors and nurses of the Department of Digestive Surgery, Hue University of Medicine and Pharmacy Hospital, for their assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tri Huu Nguyen.

Ethics declarations

Ethical Approval

The study received ethical approval from the ethics committee of Hue University of Medicine and Pharmacy, Hue City, Vietnam.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nguyen, T.H., Dang, T.N. No Abdominal Drainage After Single-Port Laparoscopic Repair for Perforated Duodenal Ulcers. Indian J Surg 83 (Suppl 4), 879–883 (2021). https://doi.org/10.1007/s12262-021-02795-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-021-02795-1

Keywords

Navigation