To evaluate the surgical outcomes in different stages of laparoscopic gastroduodenal ulcer perforation and to investigate the learning curve.

Forty-four cases [25 males and 19 females, aged from 28 to 78 years, average age (44.2±8.8)years] of perforated gastroduodenal ulcer(performed by X. J. between October 2015 and December 2017)in the Department of General Surgery were reviewed. All patients were divided into the laparoscopic group(n=33)and the laparotomy group (n=11, IV), in which the laparoscopic group were divided equally into 3 subgroups: group Ⅰ(October 2015September 2016), group Ⅱ (October 2016-May 2017), and group Ⅲ (June 2015-December 2017))according the time sequence of the operations. The relevant indicators were compared, the surgical effect at different stages was analyzed and the learning curve judged.

The indexes of operative time [(55.8±10.2)min vs.(72.3±9.4)min], intraoperative bleeding [(15.1±5.1)mL vs.(50.7±8.6)mL], antibiotics consumption [(5.6±0.3)d vs.(8.2±0.4)d], leaving bed time [(31.9±1.4)h vs(53.8±3.7)h], postoperative hospital stay [(6.5±0.4)d vs.(9.3±0.8)d], gastrointestinal movement recovery time [(3.5±0.4)d vs(4.5±0.4)d] and cost of hospitalization[(12 892±1 120)yuan vs.(14 273±1 328) yuan] were lower in laparoscopy group III than those in laparotomy group(P <0 .05). The indexes of operative time [(55.8±10.2)min vs.(72.7±11.2)min, (55.8±10.2)min vs.(65.5±9.2)min], intraoperative bleeding [(15.1±5.1)mL vs.(25.3±5.2)mL and(15.1±5.1)mL vs.(21.6±4.3)mL] were lower in laparoscopy group III than those in laparotomy group I and Ⅱ(P < 0.05); the correlation index was optimized obviously after learning curve. The operative frequency of groups Ⅰ-Ⅲ increased from 0.85/month to 2.5/month. The learning curve of laparoscopic gastroduodenal ulcer perforation for surgeon who was experienced in laparoscopic cholecystectomy was approximately 22 cases.

Laparoscopic gastroduodenal ulcer perforation can reduce the postoperative complications effectively, and has the characteristics of minimally invasive surgery, safe and reliable operation, rapid postoperative recovery, and so on, which is worthy of clinical popularization and application.