AB135. SOH24AB_111. Single centre experience with managing perforated duodenal ulcer between 2017 and 2021

Background: Patients with perforated duodenal ulcer (DU) would present in an emergency setting to the hospital. Previously, open surgery has been the approach of choice for perforated DU. Adoption of laparoscopy in emergency setting in the management of perforated DU has been slow but steadily increasing. This audit will review the background and risk factors of patients presented to the centre and also the outcomes from both open and laparoscopic surgical approach.

Methods: This was a retrospective audit of 13 patients presented to St Luke’s Hospital, Kilkenny with perforated DU between 2017 and 2021. This cohort was obtained from the Hospital In-Patient Enquiry Department. The background of the patients was reviewed together with the surgical approach and outcomes of surgery.

Results: From 13 patients admitted with perforated DU, 8 patients had laparoscopic surgery, 3 patients had open surgery while 2 patients had laparoscopic surgery converted to open. 1 patient from open surgery group was admitted to intensive care unit (ICU) post-surgery. Average length of stay in ward was 6 days for laparoscopy group, 10 days for open group and 11 days for laparoscopy converted to open group. No mortality or postoperative complications recorded.

Conclusions: Numbers gathered from our site showed convincing outcomes with patients undergoing laparoscopy intervention stayed for a shorter period in the hospital and had similar mortality and postoperative complications compared to open technique. Laparoscopic approach offers lower postoperative pain, faster recovery rate, reduced length of stay and lesser surgical site infection. Laparoscopic surgery is also cosmetically superior than open surgery.

Keywords: Emergency general surgery; laparoscopic surgery; open surgery; perforated duodenal ulcer (perforated DU); surgical approach