Comparison of the Efficacy of Laparoscopic and Open Surgery for Gastric and Duodenal Ulcer Perforation Repair

TAO Hanchuan; WANG Yue; ZHU Xun

doi:10.13919/j.issn.2095-6274.ZHJY202503022

Abstract：Objective To explore the clinical efficacy differences between laparoscopic repair and open repair for the treatment of gastric and duodenal ulcer perforations,providing a reference for the selection of surgi-cal approaches.Methods This study retrospectively analyzed 88 patients with perforated gastric or duodenal ulcers treated at our hospital between January 2020 and January 2023.The patients were divided into two groups based on the surgical method:44 patients who underwent open surgery were assigned to the control group,and 44 patients who underwent laparoscopic surgery were assigned to the observation group.Relevant intraoperative and postoperative indicators,postoperative pain levels,gastrointestinal function markers,inflammatory markers,im-mune function parameters,and postoperative complication rates were statistically analyzed and compared between the two groups.Results The observation group had significantly shorter incision length,earlier first flatus,and shorter time to ambulation compared to the control group(P＜0.05).Intraoperative blood loss and hospital stay were also significantly lower in the observation group(P＜0.05).The observation group exhibited lower VAS pain scores and a lower incidence of postoperative complications compared to the control group(P＜0.05).The levels of D-lac-tic acid,endotoxin,iFABP,DAO,CRP,IL-6,IL-8,and IL-10 were significantly lower in the observation group(P＜0.05),while the levels of IgG,CD3+,CD4+,and NK cells were significantly higher in the observation group(P＜0.05).Conclusion Compared to open repair,laparoscopic repair for gastric and duodenal ulcer perforations offers advantages such as smaller trauma,quicker recovery,less postoperative pain,and fewer complications.It can more effectively improve the patient's inflammatory response and immune function,making it a more valuable clinical approach.