Retrospective comparative study of different surgical methods for gastric ulcer perforation: Efficacy and postoperative complications

Abstract

BACKGROUND

Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed. It is often the result of chronic peptic ulcer disease, which is characterized by a breach in the gastric wall due to ulceration. Surgical intervention is essential for managing this life-threatening complication. However, the optimal surgical technique remains debatable among clinicians. Various methods have been employed, including simple closure, omental patch repair, and partial gastrectomy, each with distinct advantages and disadvantages. Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making. This study addresses the need for a comprehensive analysis in this area.

AIM

To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.

METHODS

A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023. The patients were divided into three groups based on the surgical method: Simple closure, omental patch repair, and partial gastrectomy. The primary outcomes were the operative success rate and incidence of postoperative complications. Secondary outcomes included the length of hospital stay, recovery time, and long-term quality of life.

RESULTS

The operative success rates for simple closure, omental patch repair, and partial gastrectomy were 92.5%, 95%, and 97.5%, respectively. Postoperative complications occurred in 20%, 15%, and 17.5% of patients in each group, respectively. The partial gastrectomy group showed a significantly longer operative time (P < 0.001) but the lowest rate of ulcer recurrence (2.5%, P < 0.05). The omental patch repair group demonstrated the shortest hospital stay (mean 7.2 days, P < 0.05) and fastest recovery time.

CONCLUSION

While all three surgical methods showed high success rates, omental patch repair demonstrated the best overall outcomes, with a balance of high efficacy, low complication rates, and shorter recovery time. However, the choice of the surgical method should be tailored to individual patient factors and the surgeon’s expertise.

Keywords: Gastric ulcer perforation; Surgical methods; Simple closure; Omental patch repair; Partial gastrectomy; Postoperative complications

Core Tip: This study evaluated three surgical techniques for gastric ulcer perforation: Simple closure, omental patch repair, and partial gastrectomy. While all methods are effective, omental patch repair offers the best balance of efficacy, lower complication rates, and quicker recovery. These findings emphasize the importance of tailoring surgical choices according to individual patient needs and surgeon experience.