Comparation of laparoscopic and open surgical approach in the treatment of perforated peptic ulcer Objectives: The study aims to determine if there are differences in comorbidities, frequency of complications, length of the hospital stay, mortality, and movements of inflammatory parameters in patients with perforated peptic ulcer (PPU) subjected to laparoscopy and open surgical procedure (OSP), and the difference in length of these two procedures. Study design: A cohort study with historical data. Participants and methods: Subjects of the study were patients older than 18 subjected to laparoscopic repair (LR) or OSP with diagnosed duodenal or gastric PPU, treated in the period between 2017 and 2022 at the Department of Abdominal Surgery of Clinical Hospital Center Osijek. Results: The study involved a total of 105 subjects, and 66,7 % of the subjects had comorbidities with a median average age of 64 years old. 59 subjects were male, and 46 were female. 28 subjects were subjected to LR of the PPU, and 77 were subjected to OSP. Duodenal PPU was confirmed in 29 subjects, and gastric PPU was confirmed in 76 subjects. 20 % of the subjects have experienced a state of shock during the procedure, 42,9 % have experienced postoperative complications, and 36,2 % have died in the first 30 days after the procedure. Conclusion: Subjects from the LR group had fewer comorbidities, postoperative complications, and lower mortality rates than the subjects from the OSP group. The median procedure length was 20 min less in the OSP group, and the values of inflammatory parameters were going faster toward normal values in the LR group than in the OSP group.