ArticleSurgical endoscopy2018
Laparoscopic surgery for perforated peptic ulcer: an English national population-based cohort study.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Perioperative Outcomes of No-Drain Strategy in Primary Repair of Perforated Peptic Ulcer: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Laparoscopic versus open repair of perforated peptic ulcer: systematic scoping review and in-depth evaluation of existing evidence.BJS open · 2025Article
- Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study.Surgical endoscopy · 2024Article
- Laparoscopic Treatment of Perforated Peptic Ulcer: A Propensity Score-Matched Comparison of Interrupted Stitches Repair versus Knotless Barbed Suture.Journal of clinical medicine · 2024Article
- Predicting in-hospital mortality risk for perforated peptic ulcer surgery: the PPUMS scoring system and the benefit of laparoscopic surgery: a population-based study.Surgical endoscopy · 2023Article
- Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach.Surgical endoscopy · 2023Article
- Open versus laparoscopic technique in peptic ulcus perforation, how effective are score systems?Single-center experience and literature review.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022Review
- Potential use of peptic ulcer perforation (PULP) score as a conversion index of laparoscopic-perforated peptic ulcer (PPU) repair.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study.Annals of medicine and surgery (2012) · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized controlled trials have shown that laparoscopic approach to surgery for perforated peptic ulcer (PPU) is associated with improved short-term outcomes; however, there is limited evidence concerning national practice. The aim of this investigation was to evaluate the effect of laparoscopic approach to PPU surgery upon mortality and morbidity in England.
methodsPatients with a primary diagnosis of PPU, admitted as an emergency to a hospital in England, and receiving surgical intervention, between 2005 and 2012 were identified from the Hospital Episode Statistics database. Outcomes analyzed included 30-day and 90-day mortality, 30-day complications, and length of hospital stay. Univariate and multivariate analyses were used to identify patient, hospital, and treatment-related factors associated with use of laparoscopy and mortality.
resultsThe study included 13,022 patients who underwent emergency surgery for PPU in England over an 8-year period. From 2005 to 2012, the utilization of laparoscopic surgery for PPU increased from 0 to 13% and was more commonly used in high volume emergency centers. Laparoscopic surgery was associated with significant reductions in 30-day (7% vs. 15.7%; P < 0.001) and 90-day mortality (8.9% vs. 19.6%; P < 0.001), pneumonia (6% vs. 10.1%; P < 0.001), ischemic cardiac events (1% vs. 2.4%; P = 0.007), as well as length of hospital stay (median 5 vs. 7 days; P < 0.001). Factors associated with a reduced utilization of laparoscopic surgery included age ≥ 70 years (Odds ratio (OR) = 0.58 (95% CI) 0.49-0.68) and Charlson Comorbidity Index score ≥ 2 (OR = 0.73; 95% CI 0.57-0.94).
conclusionThe rate of laparoscopic repair of PPU is increasing at a national level and more common in high volume emergency centers. It is associated with reduced rates of mortality; pneumonia and shorter length of hospital stay, highlighting the need for strategies to improve dissemination of laparoscopic techniques necessary for PPU repair.
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