[Obstruction of the small intestine and celioscopic viscerolysis]

The authors treated 16 patients with small bowel obstruction by 19 laparoscopy (3 patients underwent 2 laparoscopies). The operation was performed 4 times as an emergency and in 15 cases after resolution of the obstruction in patients who had already experienced such attacks. Adhesiolysis was complete in 14 cases and incomplete in 5 cases. Conversion in laparotomy was necessary in one patient to cure a total obstruction. 2 operative complications were reported (bowel perforation during enterolysis); one of which required conversion into laparotomy). This patient also developed post-operative complications whereas the post-operative course was uneventful for the other patients. Five patients developed an obstructive recurrence which required laparotomy in 2 cases and laparoscopy in the other 3 cases; but for two patients, initial enterolysis had been incomplete and a laparotomy was performed on another patient. Laparoscopic viscerolysis seems to be attractive but, the long-term outcome, and the frequency of adhesion recurrence need to be defined.