Open vs laparoscopic repair of perforated peptic ulcer

Most studies have found that the only advantage to the laparoscopic treatment of perforated peptic ulcer is a reduced need for postoperative analgesia. Therefore, we set out to assess the short-term outcome of open (OR) versus laparoscopic (LR) repair of perforated peptic ulcer. A total of 62 consecutive OR patients were compared with a concurrent cohort of 17 diagnosis-matched LR controls treated at the same hospital between 1991 and 1996. The OR and LR patients were comparable for age, weight, American Society of Anesthesiologists (ASA) grade, Acute Physiology and Chronic Health Evaluation (APACHE II) score, Boey score, ulcer site, Mannheim Peritonitis Index (MPI), delay of surgery, Helicobacter pylori infection, nonsteroidal antiinflammatory drug (NSAID) intake, and previous abdominal surgery. More LR than OR patients were operated on by staff surgeons (chi2 = 46.9, 1 d.f., p