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Category: Volume 07 Issue 05 May 2019
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Title: A Case Study of Graham’s Omentopexy, Figure of 8 and Laparoscopy Procedure in the Treatment of Perforated Duodenal Ulcers

Authors: Dr Pravin K. Ladda, Dr Anita Kandi , Dr Anagha Varudkar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.112

Abstract

Purpose: The purpose of the present study is to examine the Grahms Omentopexy, Figure of 8 and Laparoscopic peptic ulcer perforation closure procedure and the associated operative risks among the patients.

Method: The study was conducted among 180 patients who were admitted at the Tertiary care centre with gastric perforations. The perforation present in all the study subjects was closed using either Grahms patch (omentopexy), Figure of 8 or Laparoscopy under general anaesthesia. Any complications such as wound complication, pleural effusion, lung consolidation or biliary leak, death were recorded. The data obtained were recorded and suitable statistical analyses were performed.

Results: The mean time taken for starting oral feeding, the time for removal of Ryle’s tube as well as the length of hospital stay was found to be the highest among the patients operated using Grahms patch while the least was observed for patients performed using laparoscopy. The percentage of patients with wound complications, lung complications, biliary fistula and death post surgery was found to be the highest in the Grahms patch group and lowest for the laparoscopic group. It was also observed that patients with smoking, alcohol consumption habit and history of APD had a higher risk for increased perforation size.

Conclusion: The study concluded that Figure of 8 being a new technique can be used in small, friable edges of perforation, and having less post operative complications than Grahms patch and also decreases length of hospital stay, oral feeding start as well as Ryle’s tube removal day.

Keywords: Biliary fistula, Figure of 8, Grahm’s Omentopexy, Laparoscopic, Peptic ulcer perforation.

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Corresponding Author

Dr Pravin K. Ladda

Department of Surgery, Govt. Medical College, Aurangabad (M.S.), India