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Observational Study
. 2024 Jul 4;409(1):205.
doi: 10.1007/s00423-024-03393-x.

Excisional biopsy of perforated gastric ulcer: mandatory or potentially harmful?

Faruk Koca  1 , Christine Koch  2 , Falko Schulze  3 , Ursula Pession  4 , Wolf O Bechstein  4 , Patrizia Malkomes  4
Affiliations
Observational Study

Excisional biopsy of perforated gastric ulcer: mandatory or potentially harmful?

Faruk Koca et al. Langenbecks Arch Surg. .

Abstract

Purpose: This study aimed to evaluate the morbidity associated with excisional biopsy in patients with spontaneous gastric perforation.

Methods: A retrospective, single-center, observational study was performed. All consecutive patients with spontaneous gastric perforation who underwent surgical therapy were included. Outcomes were assessed concerning the performance of excisional biopsy.

Results: A total of 135 adult patients were enrolled. Of these, 110 (81.5%) patients underwent excisional biopsy, while 17 (12.6%) did not. The remaining eight (5.9%) patients who underwent gastric resection were excluded from the analysis. Patients undergoing excisional biopsy developed significantly higher rates of postoperative complications (p = 0.007) and experienced more severe complications according to the Clavien-Dindo classification, particularly type III and above (p = 0.017). However, no significant differences were observed regarding in-hospital mortality, reoperation, suture dehiscence, or length of hospital stay.

Conclusion: Excisional biopsy for gastric perforation has been shown to be associated with increased morbidity. Surgical closure followed by early endoscopic biopsy may be a superior approach for gastric perforation management to rule out malignancy.

Keywords: Gastric cancer; Peptic ulcer; Spontaneous gastric perforation; Ulcer excision.

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Conflict of interest statement

The authors declare no competing interests.

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