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Combination of endoscopic and interventional radiological drainage effectively reduces operative time, postoperative hospital stay, complications, and need for general anesthesia in peptic ulcer patients.
According to the findings of a randomized clinical trial, combined endoscopic and interventional radiological drainage is effective for the management of peptic ulcer without the requirement of general anesthesia, with short operative time, in high-risk surgical patients with reduced occurrence of mortality and morbidity. Said Negm et al. aimed to evaluate the efficacy of concurrent endoscopic and interventional radiological intervention versus surgical (laparoscopic/open) therapy to reduce overall surgical complications, and the rate of mortality and morbidity.
Overall, 100 subjects with acute perforated peptic ulcer manifestations were included and segregated into two equal groups. People in the surgical group (n = 50, median age = 36) received surgical management and people in the endoscopic group (n = 50, median age = 47) received endoscopic management. The median length of postoperative hospital stay was found to be 7 (range 6-8) days and 1 (range: 1-2) day in the surgical group and the endoscopic group, respectively.
In the form of incisional hernia, renal failure, leak, pneumonia, fever, and abdominal abscess, the postoperative complications were found to be 24% in the endoscopic group and 58% in the surgical group. Therefore, concurrent endoscopic and interventional radiology approach was a valuable tool to manage patients who presented with manifestations of acute perforated peptic ulcer.
World Journal of Emergency Surgery
Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
Said Negm et al.
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