Peptic ulcer perforation is a common life-threatening surgical emergency. Graham omental patch is performed for plugging of perforated peptic ulcer. Many endoscopic methods have been used to treat acute perforated peptic ulcer such as over the scope clips, standard endoscopic clips, endoscopic sewing and metallic stents. The main idea in endoscopic management of acute perforated peptic ulcer is early decontamination and decrease sepsis by interventional radiologic drainage. This is a prospective randomized controlled clinical trial. This study included patients who were developed acute perforated peptic ulcer manifestations and were admitted to our hospital between December 2019 and August 2021. Sample size was 100 patients divided into 2 equal groups. Endoscopic group (EG): included 50 patients who were subjected to endoscopic management. Surgical group (SG): included 50 patients who were subjected to surgical management. One hundred patients were randomized into 2 groups: SG (50) and EG (50). Median age of patients was 36 (range 27:54) and 47 (range 41:50) years-old in SG and EG, respectively. Males constituted 72% and 66% in SG and EG, respectively. Median length of postoperative hospital stay was 1 (range: 1–2) days in EG, while in SG was 7 (range 6–8) days. Postoperative complications in SG patients were 58% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (11%, 5%, 5%, 3%, 2% and 3%, respectively). Postoperative complications in EG patients were 24% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (10%, 0%, 2%, 0%, 0% and 0%, respectively). Combined endoscopic and interventional radiological drainage can effectively manage acute perforated peptic ulcer without the need for general anesthesia, with short operative time, in high risk surgical patients with low incidence of morbidity & mortality.

中文翻译：

---

内窥镜和放射学联合干预治疗急性穿孔性消化性溃疡：一项随机对照试验

消化性溃疡穿孔是一种常见的危及生命的外科急症。格雷厄姆大网膜补片用于堵塞穿孔的消化性溃疡。许多内窥镜方法已用于治疗急性穿孔性消化性溃疡，例如超镜夹、标准内窥镜夹、内窥镜缝合和金属支架。急性穿孔性消化性溃疡内镜治疗的主要思路是通过介入放射引流早期净化和减少脓毒症。这是一项前瞻性随机对照临床试验。本研究纳入2019年12月至2021年8月期间入住我院的出现急性穿孔性消化性溃疡表现的患者。样本量为100名患者，分为2个相等的组。内镜组（EG）：包括 50 名接受内镜治疗的患者。手术组（SG）：包括 50 名接受手术治疗的患者。100 名患者被随机分为 2 组：SG (50) 和 EG (50)。SG 和 EG 患者的中位年龄分别为 36 岁（范围 27:54）和 47 岁（范围 41:50）。SG 和 EG 中男性分别占 72% 和 66%。EG 术后住院时间中位为 1 天（范围：1-2）天，而 SG 为 7 天（范围：6-8）天。SG 患者的术后并发症为 58%，包括发热、肺炎、漏气、腹腔脓肿、肾功能衰竭和切口疝（分别为 11%、5%、5%、3%、2% 和 3%）。EG 患者的术后并发症为 24%，包括发烧、肺炎、漏气、腹腔脓肿、肾衰竭和切口疝（分别为 10%、0%、2%、0%、0% 和 0%）。内镜联合介入放射引流可以有效治疗高危手术患者的急性穿孔性消化性溃疡，无需全身麻醉，手术时间短，发病率和死亡率低。