Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review

Perforated peptic ulcer (PPU) is developed in 2%–10 % of peptic ulcer. The essential treatment is emergent surgical repair. Usually, the surgical repair with or without an omental patch is performed by laparotomy. The laparoscopic emergency surgery (LES) for PPU is increasingly being preferred with...

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Main Author: Jung Min Bae
Format: Article
Language:English
Published: Korean Society of Acute Care Surgery 2025-03-01
Series:Journal of Acute Care Surgery
Subjects:
Online Access:http://jacs.or.kr/upload/pdf/jacs-2025-15-1-1.pdf
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author Jung Min Bae
author_facet Jung Min Bae
author_sort Jung Min Bae
collection DOAJ
description Perforated peptic ulcer (PPU) is developed in 2%–10 % of peptic ulcer. The essential treatment is emergent surgical repair. Usually, the surgical repair with or without an omental patch is performed by laparotomy. The laparoscopic emergency surgery (LES) for PPU is increasingly being preferred with the innovation of laparoscopic devices and procedures and increase of surgeon’s expertise and experiences. Generally, a laparoscopic approach is recommended in stable patient. And, in selected patient with instability, a laparoscopic approach may be adopted. The patient selection criteria is recommended in hemodynamic stability, surgeon’s skills, cardiovascular or pulmonary comorbidity and Boey score. These LES rate differences for PPU are resulted that the variability in the healthcare infrastructure and patient-related factors between countries. The surgeon’s decision about LES for PPU is affected by various factors. Even surgeon’s fatigue, physical strength, stressful feelings and poor emotional mood may be one of factors. According to published literature, the practical LES performance is affected by various limiting factors. Although guideline about laparoscopic emergency knotless suture repair for PPU is absent, the 4 retrospective studies about LES for PPU between knotless and interrupted suture repair revealed that the laparoscopic knotless suture repair using barbed suture material is alternative, feasible, safe, simple and non-inferior method. However, the recommendation evidence about single port LES for PPU is unclear.
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spelling doaj-art-cf093f201ea14d22a3b19bae07d1f06a2025-08-20T03:53:46ZengKorean Society of Acute Care SurgeryJournal of Acute Care Surgery2288-58622288-95822025-03-011511410.17479/jacs.2025.15.1.1312Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative ReviewJung Min BaePerforated peptic ulcer (PPU) is developed in 2%–10 % of peptic ulcer. The essential treatment is emergent surgical repair. Usually, the surgical repair with or without an omental patch is performed by laparotomy. The laparoscopic emergency surgery (LES) for PPU is increasingly being preferred with the innovation of laparoscopic devices and procedures and increase of surgeon’s expertise and experiences. Generally, a laparoscopic approach is recommended in stable patient. And, in selected patient with instability, a laparoscopic approach may be adopted. The patient selection criteria is recommended in hemodynamic stability, surgeon’s skills, cardiovascular or pulmonary comorbidity and Boey score. These LES rate differences for PPU are resulted that the variability in the healthcare infrastructure and patient-related factors between countries. The surgeon’s decision about LES for PPU is affected by various factors. Even surgeon’s fatigue, physical strength, stressful feelings and poor emotional mood may be one of factors. According to published literature, the practical LES performance is affected by various limiting factors. Although guideline about laparoscopic emergency knotless suture repair for PPU is absent, the 4 retrospective studies about LES for PPU between knotless and interrupted suture repair revealed that the laparoscopic knotless suture repair using barbed suture material is alternative, feasible, safe, simple and non-inferior method. However, the recommendation evidence about single port LES for PPU is unclear.http://jacs.or.kr/upload/pdf/jacs-2025-15-1-1.pdfpeptic ulcer perforationlaparoscopyemergency
spellingShingle Jung Min Bae
Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
Journal of Acute Care Surgery
peptic ulcer perforation
laparoscopy
emergency
title Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
title_full Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
title_fullStr Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
title_full_unstemmed Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
title_short Laparoscopic Emergency Surgery for Perforated Peptic Ulcer: A Narrative Review
title_sort laparoscopic emergency surgery for perforated peptic ulcer a narrative review
topic peptic ulcer perforation
laparoscopy
emergency
url http://jacs.or.kr/upload/pdf/jacs-2025-15-1-1.pdf
work_keys_str_mv AT jungminbae laparoscopicemergencysurgeryforperforatedpepticulceranarrativereview