KẾT QUẢ MỔ MỞ ĐIỀU TRỊ THỦNG Ổ LOÉT DẠ DÀY TÁ TRÀNG CÓ SỬ DỤNG DÂY CHẰNG TRÒN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Introduction: Open surgery is often indicated in patients that are ineligible for undergoing endoscopic procedures; in order to strengthen the sutures thus avoiding leakage, the falciform ligament is often utilised beside greater omentum. Objects: Evaluation of surgical treatment results and relevant factors of open surgery using the falciform ligament in Bachmai Hospital. Subjects and Methods: Descriptive, retrospective research on 64 patients underwent open surgery of gastroduodenal perforation closure with falciform ligament from January 2018 to June 2023. Results: The average age of our research patients was: 67.53±14.67 (38-97) years old. Perforation diameters (mm):  5 – ≤10: 78.1%; > 10: 21.9%; site: duodenum, pyloric, pre-lyporic was 79,7%, 15,6%,4,7%; characteritic: soft, hard was 68,8%, 31,3%. The average hospital stay length was 9.42±6.02 (1-26) days, postoperative ileus was 4.05±1.19 days. Postoperative complications: gastrointestinal leakage, pneumonitis, surgical wound infection, acute liver failure, multiple organ failure and mortality rate was 0%, 20,3%, 6,3%, 4,7%, 12,5 and 7,8 %; After one month of follow-up (n=38): Visick 1,2,3: 2,6%,44.7%, 52.6 %; after 6 months (n-23): Visick 1,2,3: 76.7%,23.3%,0%; gastric endoscopy shown that 86.7% of injuries was healed and 13.3% still persisted with ulcer. Simple logistic regression analysis results for mortality rate associated with complications: pneumonitis(p=0,041), acute liver failure (p=0.007), multiple organ failure (p=0.001); multivariate logistic regression analysis results for mortality rate associated with complication: multiple organ failure (p=0.012). Conclusion: The usage of the falciform ligament in gastroduodenal perforation closure is a feasible technique. Multiple organ failure is an independent factor associated with postoperative mortality.