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ORIGINAL ARTICLE
Year : 2013  |  Volume : 1  |  Issue : 2  |  Page : 33-36

Modified Grahams' omentopexy in acute perforation of first part of duodenum; A tertiary level experience in South India


Department of General Surgery, M.K.C.G. Medical College and Hospital, Brahmapur, Odisha, India

Correspondence Address:
Mani Charan Satapathy
Department of General Surgery, M.K.C.G. Medical College and Hospital, Brahmapur, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3846.125032

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Background: Despite the rarity (5%) of acute perforation of first part of duodenum (D1) and the advancement in surgical, anesthetic and ancillary facilities, still there are life-threatening dimensions. A variety of surgical techniques evolved over time, but none is without drawbacks. Thus, the need arise for surgeon friendly, suitable surgical technique with better outcome. By this retrospective analysis, we aimed to compare between the Graham's omentopexy (GO) and modified Grahams' omentopexy (MGO) to find the suitable method of managing this acute catastrophe. Materials and Methods: This is a retrospective study design for the period June 2009-May 2012. All the patients with only D1 perforation admitted and treated at our institution were included. Patients with perforation other than D1 site, multiple perforations, poly-trauma and associated co-morbidity were excluded. Patients were randomly subjected for either GO or MGO. Post-operatively, all were followed-up for 3 months at out-patients department. Results: Out of the 122 patients, 112 were males and 10 were females with M:F ratio 11.2:1. MGO group had comparatively less chances of biliary fistula, burst abdomen and mortality, but, more chances of wound infections with longer hospital stay and better outcome at 3 month follow-up in contrast to GO group. The overall mortality rate was 4.09%. Conclusion: MGO is surgically suitable technique than GO for patients with D1 perforation with better post-surgical outcome.


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