Project overview
This retrospective observational study assessed the value of routine intraoperative biopsy in patients with spontaneous gastric perforation peritonitis (GPP). Among 74 patients undergoing surgery between 2021 and 2024, all intraoperative biopsies revealed benign inflammatory findings, with no malignancies detected. In 81% of patients who underwent postoperative endoscopy, benign pathology was again confirmed. Gastric mucosa was clearly identified in 89.2% of biopsy samples, while 10.8% showed ambiguous or duodenal mucosa. Despite historical concern over missing gastric cancers, this study found no malignancies and highlights the low diagnostic yield of routine biopsies. Given modern access to safe and effective endoscopic evaluation, the authors argue that routine intraoperative biopsy may no longer be necessary. Instead, selective biopsy guided by clinical suspicion and postoperative endoscopy may optimize care while avoiding unnecessary procedures.
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