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[Laparoscopic management of small-bowel obstruction]
Davide Cavaliere1, Angelo Schirru, Ilario Caristo
1Dipartimento di Chirurgia, Ospedale San Paolo, ASL2 Savonese, Savona.
Chirurgia Italiana
|May 27, 2005
Summary
Laparoscopic surgery for acute small-bowel obstruction is safe and effective, even in patients with prior abdominal surgeries. Early consideration of laparoscopy can lead to successful treatment, justifying its use in managing this condition.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Oncology
Context:
- Laparoscopy is often debated for abdominal emergencies, especially in patients with prior surgeries and intestinal obstruction.
- Acute small-bowel obstruction presents significant clinical challenges.
- Assessing the efficacy and safety of laparoscopic approaches is crucial.
Purpose:
- To analyze the efficacy and safety of laparoscopic surgery for acute small-bowel obstruction.
- To evaluate outcomes in patients with a history of abdominal operations.
Summary:
- A retrospective study of 44 patients with radiologically documented small-bowel obstruction treated laparoscopically between 2000-2003.
- 89% of patients had prior abdominal surgeries (mean 2 laparotomies).
- Laparoscopic procedures were completed in 28/44 patients; 10 required conversion to laparotomy due to adhesions, view, or bowel conditions. Mean operative time was 58 min, mean hospital stay was 6 days, with 2% mortality and 16% morbidity.
Impact:
- Suggests laparoscopy should be considered early for acute small-bowel obstruction.
- Demonstrates that definitive treatment is possible, effective, and safe in most patients.
- Supports the early laparoscopic approach for improved patient outcomes.