{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:37:37Z","timestamp":1777448257729,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Peptic ulcer perforation (PUP) is a severe complication of peptic ulcer disease, associated with significant morbidity and mortality. The Graham patch repair (GPR) is the standard surgical treatment; however, when the greater omentum is insufficient, falciformopexy has emerged as a viable alternative. This study aims to assess the efficacy and safety of falciformopexy for PUP through a systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in PubMed, Scopus, Cochrane, Web of Science, and Ovid to identify studies reporting on PUP patients treated with falciformopexy. Outcomes evaluated included length of hospital stay, perioperative mortality, wound infections, and reoperation rates. A comparative analysis with patients treated with GPR was also performed. Safety and efficacy outcomes were analyzed using single proportions, while risk ratios (RR) with 95% confidence intervals were pooled for comparative assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies involving 868 patients were included, of whom 148 underwent falciformopexy for PUP. The mean hospital stay was 8.76 days (95% CI: 6.5-11.02; I\n                      <jats:sup>2<\/jats:sup>\n                      = 92%). The perioperative mortality rate was 4.38% (95% CI: 0%-10.26%; I\n                      <jats:sup>2<\/jats:sup>\n                      = 53%), the wound infection rate was 6.66% (95% CI: 2.31%-11.02%; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), and reoperation was required in 1.76% of cases (95% CI: 0%-4.73%; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). Comparative analysis revealed no significant differences between the falciformopexy and GPR groups regarding mortality, wound infections, or reoperation rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results indicate that the use of the falciform ligament for PUP repair is associated with low perioperative mortality, wound infection, and reoperation rates, suggesting it is a viable alternative when the omentum is unavailable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251323722","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:44:27Z","timestamp":1740383067000},"page":"859-870","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of the Falciformopexy Technique for Peptic Ulcer Perforation: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9130-3143","authenticated-orcid":false,"given":"Leonardo Janu\u00e1rio Campos","family":"Cardoso","sequence":"first","affiliation":[{"name":"School of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kleuber Arias Meireles","family":"Martins","sequence":"additional","affiliation":[{"name":"School of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Vitor Marques","family":"Xavier","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe Gabriel Oliveira","family":"Nascimento","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Henrique Gibram","family":"Gontijo","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Lima","family":"Minkauskas","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabela Coutinho","family":"Faria","sequence":"additional","affiliation":[{"name":"School of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronaldo Duarte Ara\u00fajo","family":"Abreu","sequence":"additional","affiliation":[{"name":"School of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre Lages Savassi","family":"Rocha","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Hospital Orizonti, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Walker V\u00e1squez","family":"Del Aguila","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Hospital Orizonti, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v9.i1.1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)00276-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-019-0283-9"},{"issue":"64","key":"e_1_3_3_5_2","first-page":"235","article-title":"The treatment of perforated duodenal ulcers","volume":"64","author":"Graham RR","year":"1937","unstructured":"Graham RR. The treatment of perforated duodenal ulcers. Surgery Gynecology Obstetric. 1937;64(64):235.","journal-title":"Surgery Gynecology Obstetric"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(46)90367-4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000264653"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","unstructured":"Boshnaq M Thakrar A Martini I Doughan S. Utilisation of the falciform ligament pedicle flap as an alternative approach for the repair of a perforated gastric ulcer. BMJ Case Rep. 2016;2016. doi:10.1136\/bcr-2015-213025","DOI":"10.1136\/bcr-2015-213025"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjaa243"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1978.01370220095016"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18806"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2740-3"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.03.2012.6015"},{"key":"e_1_3_3_14_2","first-page":"144","article-title":"Marginal ulcer perforation repair with falciform ligament: case report","volume":"5","author":"Calis H","year":"2016","unstructured":"Calis H, Cetin M, Sahin S, Nuraydin O, karabeyoglu S. Marginal ulcer perforation repair with falciform ligament: case report. Causapediacom. 2016;5:144-177. https:\/\/causapedia.com\/manuscript\/1468\/article\/genel-cerrahi\/marjinal-ulser-perforasyonunun-falciform-ligaman-ile-onarimi-olgu-sunumu.htm?abstract=1. Accessed 17 August 2024.","journal-title":"Causapediacom"},{"issue":"2","key":"e_1_3_3_15_2","first-page":"91","article-title":"[Treatment of perforated peptic ulcer using the round ligament under celioscopy]","volume":"128","author":"Costalat G","year":"1991","unstructured":"Costalat G, Dravet F, Alquier Y, Noel P, Vernhet J. [Treatment of perforated peptic ulcer using the round ligament under celioscopy]. J Chir. 1991;128(2):91-93.","journal-title":"J Chir"},{"key":"e_1_3_3_16_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J","year":"2023","unstructured":"Higgins J, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane; 2023. https:\/\/www.training.cochrane.org\/handbook.Version 6.4."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"issue":"4","key":"e_1_3_3_19_2","first-page":"390","article-title":"Laparoscopic repair of perforated duodenal ulcers with a falciform ligament patch","volume":"78","author":"Munro Ws","year":"1996","unstructured":"Munro Ws, Bajwa F, Menzies D. Laparoscopic repair of perforated duodenal ulcers with a falciform ligament patch. PubMed. 1996;78(4):390-391.","journal-title":"PubMed"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18728"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","unstructured":"Son Tran Que Hoc Tran Hieu Huong Tran Thu et al. Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: a cross-sectional study at a single centre in Vietnam. Annals of Medicine and Surgery. 2021;67. doi:10.1016\/j.amsu.2021.102477","DOI":"10.1016\/j.amsu.2021.102477"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.14744\/tjtes.2023.53246"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.05050.x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-003-0184-0"},{"issue":"2","key":"e_1_3_3_25_2","first-page":"163","article-title":"Repair of common bile duct injury with the round and falciform ligament after clip necrosis: case report","volume":"4","author":"Chang EG","year":"2000","unstructured":"Chang EG. Repair of common bile duct injury with the round and falciform ligament after clip necrosis: case report. PubMed. 2000;4(2):163-165.","journal-title":"PubMed"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-008-0456-6"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-012-1888-4"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.05.090"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2021.04.006"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211067991"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-10881-0"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.14744\/tjtes.2019.11387"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000003799"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.02.030"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-018-4047-8"},{"key":"e_1_3_3_36_2","unstructured":"ClinicalTrials.gov. Falciformopexy for treatment perforated peptic ulcer. Clinicaltrials.gov. 2024. https:\/\/clinicaltrials.gov\/study\/NCT05715450#study-plan. Accessed 17 August 2024."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.15252\/embr.202052327"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251323722","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251323722","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251323722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:37:27Z","timestamp":1777379847000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251323722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/00031348251323722"],"URL":"https:\/\/doi.org\/10.1177\/00031348251323722","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}