Updates in laparoscopic surgery for perforated peptic ulcer disease: state of the art and future perspectives

Peptic ulcer disease (PUD), which affects 4 million people worldwide annually, has a perforation rate of between 2% to 14%. Perforated peptic ulcer (PPU) carries a substantial morbidity and mortality. Surgical repair remains the treatment of choice for a PPU. This literature review includes the latest updates in laparoscopic repair techniques for a PPU and also focuses on its causation, clinical features, diagnostic workup, laparoscopic and open surgical techniques, outcomes, and future perspectives. An extensive review of the literature was performed, and the most recent meta-analyses and reviews concerning the topic were considered. No substantial differences were found in postoperative mortality between the open and laparoscopic approaches for patients with a PPU. Furthermore, a laparoscopic repair lead to statistically significantly less postoperative pain and carried a lower risk of wound infection. Hence, a laparoscopic repair is justified, where situationally appropriate, as the treatment of choice.