DOI: 10.14260/jemds/2014/2591 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 3/ Issue 19/May 12, 2014 Page 5299 A NEW AND SAFER SURGICAL TECHNIQUE FIGURE OF EIGHT STITCH FOR MANAGEMENT OF PERFORATED PEPTIC ULCER Lalit Choudhary 1 , Abhilasha Jyala 2 , P. K. Jha 3 , Pankaj Kumar Verma 4 , Sudhanshu Kiran 5 HOW TO CITE THIS ARTICLE: Lalit Choudhary, Abhilasha Jyala, P. K. Jha, Pankaj Kumar Verma, Sudhanshu Kiran. “A New and Safer Surgical Technique Figure of Eight Stich for Management of Perforated Peptic Ulcer”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 19, May 12; Page: 5299-5306, DOI: 10.14260/jemds/2014/2591 ABSTRACT: There are many methods for closing the perforated peptic ulcer. The technique of closure of perforation by figure of 8 stitch method has been found to be very effective in managing patients with this common problem. MATERIAL AND METHOD: The present study was conducted in Unit III of Department of General Surgery, Government Medical College and Dr. Susheela Tiwari Government Hospital Haldwani, from January 2012 to December 2013 on the cases of peptic ulcer perforation peritonitis. All patients with clinical and radiological features and intraoperative findings suggestive of perforated peptic ulcer were included in the study. RESULTS: A total of 153 patients were included in the study. Out of these, 128 patients (84%) were males and 25 patients (16%) were females. In 120 patients (78%) there was duodenal perforation and in 33 patients (22 %) gastric perforation was present. Out of these 33 patients, 6 patients had posterior gastric perforation. 140 patients were managed with midline laparotomy and 13 with laparoscopic method, with one converted to open due to presence of posterior gastric perforation. The average time of patient reporting to the emergency was3-4 days, with earliest reporting time of 2-3 hours and late reporting up to 7-8 days. Age ranged from 15 years to 90 years (average 35 - 45 years). In the postoperative period, 3 patients had leakage from repair site, 7 patients died, rest showed good outcome. CONCLUSION: Figure of 8 stitch method showed very good and acceptable result. Therefore, in our opinion this method should be promoted for surgery of perforated peptic ulcer. KEYWORDS: perforated peptic ulcer, figure of 8 stitch, laparotomy, Haldwani. INTRODUCTION: Gastro-duodenal perforations are common in surgical practice and do occur as a complication of peptic ulcer disease (PUD), abuse of non-steroidal anti-inflammatory drugs (NSAIDs) and gastric cancer. 1-6 Alcoholics and smokers are at higher risk. 7,8 Management is quite challenging as patients present late; with septicemia, fluid and electrolyte derangements, shock and or systemic inflammatory response syndrome. Perforated peptic ulcer is one of the most common acute abdominal condition faced by surgery residents in emergency department. As the disease mostly affects the middle and lower socio-economical class, patients usually present late in course of disease either due to ignorance or due to lake of resources. Another important factor in our study was that most of the patients in our study group belonged to hilly regions where due to lack of transportation facilities the patient took at least 3 – 4 days to reach the hospital, hence the delay. Dr. Susheela Tiwari Government Hospital is the only single tertiary care centre of Kumaun region of state of Uttarakhand which covers 6 hilly districts (Nainital, Almora, Bagheshwer, Champawat, Pithoragarh and Chamoli) and one plain district (Udham Singh Nagar). In addition patients of nearby districts of UP (Rampur, Moradabad, Bareilly, Bijnor and Badhanyu) too choose to