Omental plugging for large-sized duodenal peptic perforations: A prospective randomized study of 100 patients.

BACKGROUND

Due to friable margins and the moribund state of the patient, managing giant duodenal perforations (>20 mm in diameter) is a challenging task.

METHODS

A prospective randomized study of 100 patients with large-sized (> 20 mm) duodenal peptic perforation comparing omental plugging (study group) with omentopexy (control group) was carried out.

RESULTS

Size of the perforation varied between 20 to 30 mm. No study group patients developed a postoperative perforation site leak, as compared with 6 patients in the control group. Gastric outlet obstruction was significantly less at 6 weeks and 5 years in the study group as compared with the control group, and mortality was significantly less in the study group.

CONCLUSION

It was concluded that omental plugging was a safe and reliable method of treatment for large-sized duodenal peptic perforations.