Laparoscopic patching of crack cocaine-induced perforated ulcers.

Since the advent of "crack" cocaine use in the United States as an illicit drug, crack-related perforated ulcers have been reported in the surgical literature. An ischemic process has been postulated as a cause of these perforations. As such, an acid-reducing operative procedure is not recommended. Omental patching of these ulcers has been recommended as the procedure of choice. With the advent of laparoscopic techniques in general surgery, it is now possible to perform this procedure laparoscopically. Laparoscopy may afford the advantages of reduced morbidity, decreased hospital stay, and results potentially equal to the open technique. We present three patients with crack-related perforated ulcers that have been repaired with laparoscopic-assisted patching techniques.