Simple Closure Versus Omental Patch in the Surgical Management of Perforated Peptic Ulcer: A Meta-Analysis of Comparative Studies

Abstract

Background:

Perforated peptic ulcer (PPU) remains a surgical emergency with considerable morbidity and mortality. While both simple closure and omental patch are widely adopted repair techniques, their relative effectiveness continues to be debated. This meta-analysis aimed to compare surgical outcomes between these 2 approaches.

Methods:

A systematic search of Europe PMC, Medline, Scopus, and the Cochrane Library was performed to identify studies directly comparing simple closure and omental patch repair in patients with PPU. Data were synthesized using Review Manager 5.4. Dichotomous outcomes were expressed as odds ratios (OR) and continuous outcomes as mean differences (MD), both with 95% confidence intervals (CI). Random-effects models were applied.

Results:

Eight studies met eligibility criteria. The rates of overall complications (P = .70), postoperative leak (P = .48), ileus (P = .61), surgical site infection (P = .95), intra-abdominal collection (P = .86), reoperation (P = .24), and mortality (P = .58) showed no significant differences between groups. Similarly, length of hospital stay (MD −0.21 days, 95% CI −1.06 to 0.63) and time to resume oral intake (MD −0.08 days, 95% CI −0.89 to 0.73) were comparable. However, operative time was significantly shorter in the simple closure group (MD −21.73 minutes, 95% CI −30.15 to −13.32).

Conclusions:

Both techniques appear to have comparable safety and effectiveness across most clinical outcomes. However, simple closure is associated with a shorter operative duration, which may make it a reasonable option to consider, particularly in resource-limited or emergency settings.