Risk Factors for Gastrointestinal Leak after Operative Repair of Perforated Peptic Ulcer Disease

Document Type : Original Article

Authors

Department of General and Laparoscopic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Background: Peptic ulcer disease (PUD) is a frequent outpatient diagnosis. Although medications and precautions have
advanced to control this disease, the prevalence of PUD remains high. The complication of perforated peptic ulcer disease
(PPUD) is the most common reason for urgent PUD surgery. Therefore, it is critical to determine the risk factors for
developing a postoperative leak.
Objectives: This study aims to identify the risk factors for gastrointestinal leak after operative repair of PPUD to guide
for appropriate intraoperative decisions and postoperative care.
Patients and Methods: This is a retrospective cohort study of 60 patients who had PPUD surgically repaired at a tertiary
medical facility. The possible risk factors for postoperative leak development were recorded. Age, sex, BMI, preoperative
usage of steroids, preoperative usage of tobacco, comorbidities, vital signs at admission, preoperative albumin, preoperative
complete blood count, and perforation size were among the risk factors that were investigated.
Results: In this study, the leak occurred among six (10%) patients, and a burst abdomen among four (5%) patients, while
50 (85%) patients did not develop postoperative complications. Our results revealed that the risk factors after repair of
PPUD include older age (56.33±15.9 years), higher BMI (35.9±16.7 kg/m2), tobacco use, presence of comorbidities
(Chronic obstructive pulmonary disease, diabetes mellitus, hypertension, and liver cirrhosis), and larger size of perforation
at 3±3 cm.
Conclusion: The study demonstrated that older age, higher BMI, tobacco use, the presence of comorbidities, and a larger
size of perforation are risk factors for the development of leaks after operative repair of PPUD.

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