[Laparoscopic approach to acute abdomen: a single-center clinical experience]

in patients with acute abdomen laparoscopic procedure provides, in most cases, the simultaneous accomplishment of diagnosis and therapy with undoubted advantages.

from January 2000 to December 2006, 97 patients who presented with acute abdomen were operated by laparoscopic approach in the Unit of Laparoscopic Surgery in the University of Chieti. Of these, 53 were females and 44 males. Average age was 48 years. Seven had perforated peptic ulcer, 61 acute cholecystitis, 15 acute appendicitis, 2 idiopathic segmental necrosis of the great omentum, 6 small bowel obstruction, 6 adnexal pathologies. Pre-operative diagnosis was established in 76 patients (78.3%).

in 92 patients (94.8%) it was possible to treat the cause of the acute abdomen by laparoscopic means. In 5 cases (5.2%) it was necessary to convert the laparoscopic procedure. No mortality was noted. The morbidity was observed in 5 patients (5.2%): 3 cases of post-operative pneumonia and 2 cases of post-operative anaemia, all treated conservatively. None of the patients was re-operated. Advantages in terms of reduction in hospital stay were observed in patients operated either for acute cholecystitis or for intestinal obstruction, not in patients operated for appendectomy, adnexal pathologies or perforated peptic ulcer.

we believe that laparoscopic approach in patients with acute abdomen is safe and advantageous in most cases; however we think that it should always be preceded by non invasive diagnostic techniques.