Volume : 7, Issue : 3, March - 2018

BENEFITS AND LIMITATIONS OF DRAINS AFTER PEPTIC ULCER PERFORATION REPAIR -COMPARISON OF COMPLICATIONS IN THREE GROUPS AT A TERTIARY CARE HOSPITAL.

Dr Zaheer Ahmed, Dr Muzzafar Zaman, Dr Kunal Chowdhary, Dr Rahul Yadav

Abstract :

<p>&nbsp;</p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Background</span></b><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Peptic </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes">&nbsp;</span>ulcer </span><span lang="IN" style="font-size:&#10;14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">perforation is an emergency and requires urgent surgical </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN">intervention</span><span lang="IN" style="font-size:&#10;14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">. </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN">Nowadays ,several </span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">modalities of treatment are available ranging from conservative treatment to laparoscopic repair</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN"> of the perforation. <b style="mso-bidi-font-weight:normal"><o:p></o:p></b></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN">Aim</span></b><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN">:</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white"> To compare the post-op complications following </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white;mso-ansi-language:EN-IN">omental patch </span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white"><span style="mso-spacerun:yes">&nbsp;</span>closure of perforated peptic ulcer in </span><span lang="EN-IN" style="font-size:14.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;mso-ansi-language:&#10;EN-IN">3 </span><span lang="IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white">groups of patients as follows: </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes">&nbsp;</span>no </span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white">drain group, one-drain subhepatic group, one-drain pelvic group.</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN"><o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp;</span></span><b style="mso-bidi-font-weight:normal"><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Methods</span></b><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: This study was conducted in department of surgery</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN"> on</span><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN">90</span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> patients presenting with peptic perforation in last three years. All </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes">&nbsp;</span>the </span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">patients with </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN">pyloroduodenal perforation </span><span lang="IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp;</span>were included in the study</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN">.</span><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN"><o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Results</span></b><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Out of </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN">90</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> cases there were </span><span lang="EN-IN" style="font-size:14.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN">8</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">0 male patients and 10 female patients</span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN"> </span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white">. Post-operative </span><span lang="EN-IN" style="font-size:&#10;14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;&#10;mso-ansi-language:EN-IN">complications</span><span lang="IN" style="font-size:&#10;14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white"> were <span style="mso-spacerun:yes">&nbsp;</span></span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white;mso-ansi-language:EN-IN">similar</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white"> in the no-drain group as compared to </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white;mso-ansi-language:EN-IN">other (</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white">drain</span><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;&#10;mso-ansi-language:EN-IN">)</span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white"> groups. </span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;mso-ansi-language:EN-IN"><o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion</span></b><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: In summary,</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-ansi-language:EN-IN"> after </span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp;</span>the surgery for perforated peptic ulcer<span style="background:white"> </span></span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;&#10;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes">&nbsp;</span></span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white;mso-ansi-language:EN-IN">no drain placement is as good as</span><span lang="IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;background:white">&nbsp;</span><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white;&#10;mso-ansi-language:EN-IN">o</span><span lang="IN" style="font-size:14.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;background:white">ne drain placement and sub-hepatic drain is more useful than the pelvic drain.</span><span lang="EN-IN" style="font-size:14.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-ansi-language:EN-IN"><o:p></o:p></span></p>