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Background <p>Repair complications following surgical repair, such as leakage, are associated with high mortality, highlighting the importance of determining the best method for closing perforated peptic ulcers. Accordingly, we compared methods of primary closure for perforated peptic ulcers.</p> Methods <p>We conducted a literature search of PubMed, EBSCOhost, and the Cochrane Library for randomized trials that compared different techniques for open repair of giant and normal-sized perforated peptic ulcers (Graham’s patch, modified Graham’s patch, omental plugging, figure-of-eight repair, duodenal exclusion, jejunal serosa patch, and simple repair without an omental patch). The primary outcome was leakage of the repair.</p> Results <p>In total, 20 randomized controlled studies, mainly conducted in Asia and Africa, with six interventions and 1323 patients, were used for this network meta-analysis. Omental plugging was associated with the lowest postoperative leak rate for treating normal-sized perforated peptic ulcers (odds ratio [OR]: 0.0727; credible interval [CrI]: 0.00397, 0.608; P&#xa0;score=77.57%). In the analysis of giant ulcer perforations, the omental plug technique still had the lowest risk of postoperative leaks.</p> Conclusion <p>Omental plugging appears to be the best technique for reducing postoperative leakage in the open repair of perforated peptic ulcers. Thus, its use could have a&#xa0;positive impact on reducing postoperative morbidity associated with perforated peptic ulcers. However, generalizing these findings will require more clinical trials performed with ethnic populations that were not represented in the studies included in this network meta-analysis.</p>

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Comparison of postoperative bile leakage among techniques for open repair of perforated peptic ulcers: a network meta-analysis

  • 期刊论文

  • 发表日期：

    2026年5月6日

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  • Saburi Oyewale,
  • Azeezat Ariwoola,
  • Ezekiel Oladepo

摘要

Background

Repair complications following surgical repair, such as leakage, are associated with high mortality, highlighting the importance of determining the best method for closing perforated peptic ulcers. Accordingly, we compared methods of primary closure for perforated peptic ulcers.

Methods

We conducted a literature search of PubMed, EBSCOhost, and the Cochrane Library for randomized trials that compared different techniques for open repair of giant and normal-sized perforated peptic ulcers (Graham’s patch, modified Graham’s patch, omental plugging, figure-of-eight repair, duodenal exclusion, jejunal serosa patch, and simple repair without an omental patch). The primary outcome was leakage of the repair.

Results

In total, 20 randomized controlled studies, mainly conducted in Asia and Africa, with six interventions and 1323 patients, were used for this network meta-analysis. Omental plugging was associated with the lowest postoperative leak rate for treating normal-sized perforated peptic ulcers (odds ratio [OR]: 0.0727; credible interval [CrI]: 0.00397, 0.608; P score=77.57%). In the analysis of giant ulcer perforations, the omental plug technique still had the lowest risk of postoperative leaks.

Conclusion

Omental plugging appears to be the best technique for reducing postoperative leakage in the open repair of perforated peptic ulcers. Thus, its use could have a positive impact on reducing postoperative morbidity associated with perforated peptic ulcers. However, generalizing these findings will require more clinical trials performed with ethnic populations that were not represented in the studies included in this network meta-analysis.