Comparison of Graham Omentoplastyand Modified Graham Omentopexyin PerforatedDuodenalUlcer: A Prospective Cohort Study

Abstract

Background: Duodenal perforation is a surgical emergency and accounts for the majority of the causes of death in the elderly population. Various treatment modalities have been enrolled in the management. Still, the management of the cases is under debate. We aimed to prospectively analyse the outcome and complications of Graham Omentoplasty (GO) and Modified Graham Omentopexy (MGO).

Methodology: It was a prospective cohort study that was carried out in the tertiary care teaching hospital for a period of six months. A total of 60 patients were included and randomised using sealed envelope techniques, as group GO (n = 30) underwent GO surgical procedures and group MGO (n = 30) underwent MGO procedures. Patients were analysed for outcome and complications between both types of procedures.

Results: Age, sex, comorbid conditions, ventilatory support, return to normal bowel function, Mannheim peritonitis index, and average duration of hospital stays were statistically insignificant between GO and MGO. Duration of surgery (96 minutes in GO vs. 113 minutes in MGO) and surgical site infection (26.67% in GO vs. 20% in MGO) were found to be higher in GO than MGO but not significant. Postoperative systemic complications (6.67% in GO vs. 6.67% in MGO) and mortality (13.33% in GO vs. 13.33% in MGO) were similar in both groups and did not have a statistical difference.

Conclusions: Perforated duodenal ulcer cases can be effectively managed with either GO or MGO. Both procedures have equivalent outcomes and choices based on surgeon preference in the available clinical settings.