Prevention of Suture Dehiscence in the Repair of Perforated Gastroduodenal Ulcer
Perforation of a gastroduodenal ulcer is a life-threatening complication of peptic ulcer disease that requires emergency surgical intervention. The most common and severe complication after suturing a perforated defect is suture failure, which occurs in up to 17 % of cases. In turn, the mortality rate among patients with suture failure reaches 40 %. Timely identification of risk factors and the selection of appropriate intraoperative tactics are crucial for preventing suture failure. The key to preventing this complication is the suturing technique and the use of additional methods to strengthen the sutures during the surgery. The purpose of the review is to conduct a comparative analysis of literary data on existing approaches to the prevention of suture failure in the treatment of perforated gastroduodenal ulcers based on a classical literature review. The most significant foreign and domestic sources were analyzed using the search engines https://pubmed.ncbi.nlm.nih.gov/, https://www.elibrary.ru/, and https://cyberleninka.ru/. Conclusion. The advantages and limitations of each method for preventing suture failure have been analyzed, and their effectiveness in improving the tightness and stimulating reparative processes in the area of the sutured perforation has been substantiated. Omentoplasty remains the most studied method, demonstrating high efficiency (95 %) and a low frequency of failure. The use of laparoscopic access during the suture of a perforation defect reduces the duration of hospitalization for patients, but does not affect the frequency of suture failure. The combined use of traditional and modern techniques is considered the most promising approach to reducing the risk of suture failure in patients with gastroduodenal ulcer perforation.
Sergatskiy K.I., Ulybina D.V., Muromtseva E.V., Gavryushin M.A., Dukhovnova K.M., Kalinushkina A.O., Mohammad Aljabr, Markina O.M. 2026. Prevention of Suture Dehiscence in the Repair of Perforated Gastroduodenal Ulcer. Challenges in Modern Medicine, 49(2): 168–183 (in Russian). DOI: 10.52575/2687-0940-2026-49-2-168-183. EDN: OEWMPG
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Cira K., Stocker F., Reischl S., Obermeier A., Friess H., Burgkart R., Neumann P.A. 2022. Coating of Intestinal Anastomoses for Prevention of Postoperative Leakage: A Systematic Review and Meta-Analysis. Front Surg, 9:882173. doi: 10.3389/fsurg.2022.882173
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Fidalgo C., Iop L., Sciro M., Harder M., Mavrilas D., Korossis S., Bagno A., Palù G., Aguiari P., Gerosa G. 2018. A Sterilization Method for Decellularized Xenogeneic Cardiovascular Scaffolds. Acta Biomater, 67: 282–294. doi: 10.1016/j.actbio.2017.11.035
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Lund S., Chauhan K.K., Zietlow J., Stephens D., Zietlow S., Strajina V., Turay D., Zielinski M. 2021. Risk Factors for Gastrointestinal Leak after Perforated Peptic Ulcer Disease Operative Repair. Am Surg, 87(12): 1879–1885. doi: 10.1177/00031348211056263
Masoudpour H., Wassef J., Saladziute S., Sherman J. 2025. Surgical Therapy of Gastric Ulcer Disease. Surg Clin North Am, 105(1): 173–186. doi: 10.1016/j.suc.2024.06.013
Mohamedahmed A.Y.Y., Albendary M., Patel K., Ayeni A.A., Zaman S., Zaman O., Ibrahim R., Mobarak D. 2023. Comparison of Omental Patch Closure Versus Simple Closure for Laparoscopic Repair of Perforated Peptic Ulcer: A Systematic Review and Meta-Analysis. Am Surg, 89(5): 2005–2013. doi:10.1177/00031348211067991
Nanack J.J., Ferndale L. 2023. Factors Influencing Outcome in Patients with Perforated Peptic Ulcer Disease at a South African Tertiary Hospital. S Afr J Surg, 61(4): 207–211. doi: 10.36303/SAJS.4005
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Quah G.S., Eslick G.D., Cox M.R. 2019. Laparoscopic Repair for Perforated Peptic Ulcer Disease Has Better Outcomes than Open Repair. Journal of Gastrointestinal Surgery, 23(3):618–625. doi: 10.1007/s11605-018-4047-8
Rasslan S., Coimbra R., Rasslan R., Utiyama E.M. 2025. Management of Perforated Peptic Ulcer: What You Need to Know. J Trauma Acute Care Surg, 99(1): 1–9. doi:10.1097/TA.0000000000004561
Sokhal B.S., Mohamedahmed A.Y.Y., Zaman S., Wuheb A.A., Abdalla H.E., Husain N., Hajibandeh S., Hajibandeh S. 2025. Laparoscopic Versus Open Repair for Peptic Ulcer Perforation: A Systematic Review, Meta-Analysis and Trial Sequential Analysis Of Randomized Controlled Trials. Time to Conclude! Ann R Coll Surg Engl, 107(5): 331–345. doi: 10.1308/rcsann.2024.0082
Takahashi Y., Kobayashi A., Seki H. 2020. Successful Use of Ligamentum Teres Hepatis for Perforated Duodenal Ulcer Following Omentectomy: A Case Report. J Surg Case Rep, 2020(7): rjaa196. doi: 10.1093/jscr/rjaa196
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