January-March 2018

Graham Patch Vs Modified Graham Patch in Management of Perforated Peptic Ulcer

S O Sankhala1, D A Baraiya2, J P Dave3, I A Juneja4, J G Bhatt5, D M Gohil6

1Assistant Professor, 2Resident Doctor, 3,4Associate Professor, 5Professor & HOD, 6Professor, Dept. of Gen. Surgery, P.D.U. Govt. Medical College, Rajkot


BACKGROUND AND OBJECTIVES: Peptic ulcer remains a relatively common condition worldwide, with annual incidence ranging from 0.10% to 0.19%. Life-threatening condition in perforated peptic ulcer (PPU) is varying from 10% to 40%.To compare outcome and complications in Graham patch and Modified Graham patch repair in perforated peptic ulcer. METHODS: A retrospective study was conducted to compare the outcome and complication viz. leakage, obstruction after Graham's patch repair and modified Graham's patch repair undergoing peptic ulcer perforation in various surgical units of P.D.U. Medical College and Hospital Rajkot. The outcome of procedure was measured in terms of complication like leakage, obstruction and mortality. RESULTS: Peptic ulcer perforation in group A was more common in male; 19(95%) patients were male & 1 (5%) was female (M: F=19:1). The mean age was 43.45 years. In Group B it was more common in male; 33(82.5%) patients were male 7(17.5%) were female (M: F=4.71:1). The mean age was 40.65 years. The incidence of post-operative leakage was 1(5%) and in Group B were 2(5%). The incidence of burst abdomen was same (5%) in both the groups. CONCLUSION: The analysis of results of present study consisting of altogether 60 patients undergoing peptic ulcer perforation repair showed that Graham's patch repair is as effective as modified Graham's patch repair in terms of morbidity and mortality. It is concluded that either procedure can be undertaken depending upon surgeon preference.

Keywords: Burst abdomen, graham patch repair, leakage, modified graham patch repair

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