Köninger Jörg, Böttinger Peter, Redecke Jens, Butters Michael
Abteilung für Allgemein- und Viszeralchirurgie, Krankenhaus Bietigheim, Riedstrasse 12, 74321, Bietigheim-Bissingen, Germany,
Langenbecks Arch Surg. 2004 Feb;389(1):11-6. doi: 10.1007/s00423-003-0427-x. Epub 2003 Nov 15.
Perforated gastroduodenal ulcer represents an emergency situation that requires immediate surgical intervention. Laparoscopic ulcer repair is a feasible and safe procedure, especially in cases of a short duration of ulcer perforation and good clinical condition. However, to be well accepted as a treatment modality, an endoscopic procedure should be as simple as possible. We describe a technique that does not require intra-corporal or extra-corporal knotting.
Over a 4-year period, we performed 786 diagnostic laparoscopies for various, acute abdominal conditions. We identified 20 gastroduodenal perforations. All ulcers were closed with a one-row running suture (Lahodny) and controlled radiologically on the third postoperative day.
Three different surgeons performed the surgeries. There were no conversions to open surgery. Median operating time was 50 min, and median hospital stay was 9 days. We observed no insufficiency, no wound infection, and no stenosis or persisting peritonitis.
The closure of perforated gastric ulcers with the Lahodny suture is safe and simple to perform.
胃十二指肠溃疡穿孔是一种需要立即进行手术干预的紧急情况。腹腔镜溃疡修补术是一种可行且安全的手术，尤其是在溃疡穿孔时间短且临床状况良好的情况下。然而，要被广泛接受为一种治疗方式，内镜手术应尽可能简单。我们描述了一种无需体内或体外打结的技术。
在4年的时间里，我们对各种急性腹部疾病进行了786例诊断性腹腔镜检查。我们识别出20例胃十二指肠穿孔。所有溃疡均采用单排连续缝合（拉霍德尼缝合法）进行闭合，并在术后第三天进行放射学检查。
手术由三位不同的外科医生进行。无一例转为开放手术。中位手术时间为50分钟，中位住院时间为9天。我们未观察到吻合口漏、伤口感染、狭窄或持续性腹膜炎。
采用拉霍德尼缝合法闭合穿孔性胃溃疡安全且操作简单。
