Laparoscopy in acute abdomen between encouragement and inhibition

Authors

  • Mena Zarif Helmy Department of General Surgery, Sohag Faculty of Medicine, Sohag, Egypt
  • Ahmed Abdel Kahaar Aldardeer Department of General Surgery, Sohag Faculty of Medicine, Sohag, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20194400

Keywords:

Acute abdomen, Laparoscopy, Laparotomy

Abstract

Background: Laparoscopy has been a valuable technique in the treatment of acute abdominal diseases and can be considered either to diagnose or to treat selected cases.

Methods: Here, we randomly select patients with acute abdominal pain in whom the diagnosis was not clear after ultrasonography and plain X-ray, we did diagnostic laparoscopy and according to its findings, we proceeded to surgical intervention. 50 cases with acute abdomen were included in this study in order to clarify the role of laparoscopy in the diagnosis and treatment of acute abdomen.

Results: From the 50 patients, the main complaint was abdominal pain and presented in (100%) of patients, 38 of patients had vomiting, fever in 29 patients and 14 patients had abdominal distension, 7 patients had alteration in bowel habits and burning micturition in 6 patients. In this study, 10 patients had past history of previous surgery. By laparoscopy we could see the pathology in 46 patients and complete the management in all of patients but failed to reach the diagnosis in 2 cases and conversion to laparotomy in other 2 cases. Laparoscopic surgery mean was 47.9±12.4 minutes. Hospital stay mean was (1.851) days. Morbidity was 10%. No mortality was found in our study.

Conclusions: Laparoscopy can be considered safe for diagnosis and effective in the treatment of patients with acute abdomen. It may be useful to avoid the unnecessary laparotomies in a large number of patients presented with acute abdominal pain.

References

Lupinacci RM, Menegaux F, Trésallet C. Emergency laparoscopy: Role and implementation. J Visceral Surg. 2015;152(6):S65-S71.‏

Joseph S, Husted TL, Wacha H. Clinician’s Manual on Intra-abdominal Infections. Springer Science & Business Media; 2011.‏

Irvin M, Kidd M, Lye KD. From the lumen to the laparoscope. Arch Surg. 2004;139(10):1110-26.‏

Başkavak CG. Understanding Surgical Craft In The Changing Context Of Technology, Transformation Of Healthcare And Marketization: A Case Study On Surgeons In Istanbul, Turkey. Diss. Middle East Technical University; 2016.‏

Freitas ML, Bell RL, Duffy AJ. Choledocholithiasis: evolving standards for diagnosis and management. World J Gastroenterol. 2006;12(20):3162.‏

Jorge SA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology. 2012;265(3):678-93.‏

Wray CJ, Kao LS, Millas SG, Tsao K, Ko TC. Acute appendicitis: controversies in diagnosis and management. Curr Prob Surg. 2013;59(2):54-86.‏

Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283.‏

Montravers P, Dupont H, Leone M, Constantin JMM, Société française d’anesthésie et de réanimation (Sfar), et al. Guidelines for treatment of intra-abdominal infections. Anaesth Crit Care Pain Med. 2015;34(2):117-30.‏

Sanabria A, Villegas MI, Morales Uribe CH. Laparoscopic repair for perforated peptic ulcer disease. Cochrane Database of Systematic Reviews 2013;2:CD004778.

Francisco PA, Palmiter RD. Parkin-deficient mice are not a robust model of parkinsonism. Proceedings of the National Academy of Sciences. 2005;102(6):2174-9.‏

Jerrold Y, Gilbert AI. Gilbert Technique: PHS Bilayer Repair. The Art of Hernia Surgery. Springer, Cham; 2018: 285-299.‏

Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015;29(2):289-321.‏

Eker HH, Hansson BM, Buunen M, Janssen IM, Pierik RE, Hop WC, et al. Laparoscopic vs open incisional hernia repair: a randomized clinical trial. JAMA Surg. 2013;148(3):259-63‏.

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Published

2019-09-26

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Section

Original Research Articles