Poornima Dogra1, Robin Kaushik2, Simrandeep Singh1, Sushma Bhardwaj1. 1. Department of General Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, India. 2. Department of General Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, India. robinkaushik@yahoo.com.
Abstract
AIMS: Duodenal ulcer perforations are frequently encountered but there is limited literature regarding risk factors for leak after omentopexy. METHODOLOGY: The record of 100 patients of duodenal ulcer perforation undergoing omentopexy by open approach was prospectively maintained to identify any significant factors contributing towards leak. RESULTS: Out of 100 patients undergoing omentopexy, 9 (9%) developed leak; when leak occurred, the mortality was very high (44.4%). Patients who developed leak (09) were compared against those who did not (91), and it was seen that seen that duration of symptoms before surgery (> 3 days), amount of intra-abdominal contamination (> 2 L), low body mass index (BMI < 19.35 kg/m2), serum creatinine (> 1.5 mg/dl), and deranged International Normalized Ratio (INR) were found to be significant on univariate analysis; however, multivariate analysis revealed only low BMI and high creatinine to be contributory towards leak. CONCLUSION: Leak after omentopexy carries a high morbidity and mortality. Identification of risk factors may help in optimizing patients at risk and reduce the incidence of leak and its sequelae. TRIAL REGISTRATION NUMBER: CTRI/2020/03/023798.
AIMS: Duodenal ulcer perforations are frequently encountered but there is limited literature regarding risk factors for leak after omentopexy. METHODOLOGY: The record of 100 patients of duodenal ulcer perforation undergoing omentopexy by open approach was prospectively maintained to identify any significant factors contributing towards leak. RESULTS: Out of 100 patients undergoing omentopexy, 9 (9%) developed leak; when leak occurred, the mortality was very high (44.4%). Patients who developed leak (09) were compared against those who did not (91), and it was seen that seen that duration of symptoms before surgery (> 3 days), amount of intra-abdominal contamination (> 2 L), low body mass index (BMI < 19.35 kg/m2), serum creatinine (> 1.5 mg/dl), and deranged International Normalized Ratio (INR) were found to be significant on univariate analysis; however, multivariate analysis revealed only low BMI and high creatinine to be contributory towards leak. CONCLUSION: Leak after omentopexy carries a high morbidity and mortality. Identification of risk factors may help in optimizing patients at risk and reduce the incidence of leak and its sequelae. TRIAL REGISTRATION NUMBER: CTRI/2020/03/023798.
Authors: Sarah Lund; Kiran Kaur Chauhan; John Zietlow; Daniel Stephens; Scott Zietlow; Veljko Strajina; David Turay; Martin Zielinski Journal: Am Surg Date: 2021-11-08 Impact factor: 0.688
Authors: Antonio Tarasconi; Federico Coccolini; Walter L Biffl; Matteo Tomasoni; Luca Ansaloni; Edoardo Picetti; Sarah Molfino; Vishal Shelat; Stefania Cimbanassi; Dieter G Weber; Fikri M Abu-Zidan; Fabio C Campanile; Salomone Di Saverio; Gian Luca Baiocchi; Claudio Casella; Michael D Kelly; Andrew W Kirkpatrick; Ari Leppaniemi; Ernest E Moore; Andrew Peitzman; Gustavo Pereira Fraga; Marco Ceresoli; Ronald V Maier; Imtaz Wani; Vittoria Pattonieri; Gennaro Perrone; George Velmahos; Michael Sugrue; Massimo Sartelli; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2020-01-07 Impact factor: 5.469