MANAGEMENT OF DUODENAL ULCER PERFORATION BY RIGHT MINISUBCOSTAL INCISION

Abstract

Background: Duodenal ulcer perforation is one of the most dramatic complication of peptic ulcer and also the most common acute abdominal
emergencies faced by surgeon, which in usual circumstances can be easily diagnosed and treated. Surgery is the only modality of treatment for
perforated duodenal ulcer by right upper paramedian or midline incision for laparotomy. The present study was a comparison between the
traditional right upper paramedian incision and a newer right minisubcostal incision approach.
Methods: This prospective study was conducted on fifty patients of duodenal ulcer perforation admitted in surgical units of Krishna Hospital and
Medical Research Center, Karad. Our primary aim was to determine advantages and disadvantages of right minisubcostal incision; a new surgical
approach over the right paramedian incision approach
Results: Of the two approaches, right minisubcostal incision took lesser surgery time (67.4mins), had less post-operative hospital stay
(10.24days), showed good wound healing and minimal complications in comparison to right upper paramedian incision approach for perforated
duodenal ulcer.
Conclusion: We concluded that management of duodenal ulcer perforation by right minisubcostal incision approach is superior and beneficial to
patient as it causes lesser trauma and morbidity when compared to right upper paramedian incision approach. However, with this incision, a
definitive procedure cannot be done along with closure of duodenal ulcer perforation.