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Objective To evaluate the laparoscopy in the diagnosis and treatment for acute abdominal emergency. Methods A retrospective analysis was conducted on clinical data of 35 patients with an acute abdomen of unknown causes diagnosed and treated under laparoscope from December 1999 to April 2003 in this hospital. Results Diagnosis was confirmed by laparoscopy in all the 35 cases. Laparoscopic operation was successfully completed in 28 cases, whereas a conversion to open surgery was required in 7 cases, in which the site of incision was under the guidance of laparoscopic observations. No surgery-related deaths or wound-related complications occurred. The mean operative time was 48 min (range, 30~72 min), and the mean hospital stay was 5.8 days (range, 3~9 days). Conclusions Laparoscopy is not only a safe and accurate diagnostic method, but also a good procedure for treatment.
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Objective To evaluate the efficacy and priority of laparoscopy in the diagnosis and treatment of acute peritonitis. Methods Clinical data of 133 cases of acute peritonitis diagnosed and treated under laparoscope between April 2001 and October 2004 were retrospectively reviewed. Results Of the 133 cases, there were 60 cases of gastroduodenal perforation, 15 cases of acute cholecystitis, 8 cases of gallbladder perforation, 2 cases of sigmoid colon perforation, 35 cases of acute perforated appendicitis, 3 cases of jejunal diverticulum perforation, 1 case of foramen of Winslow hernia, 4 cases of acute pancreatitis, and 5 cases of primary peritonitis. The diagnostic accuracy was 100%. All the patients were treated laparoscopically without complications. Conclusions Laparoscopy gives a high diagnostic accuracy for acute peritonitis. The rationale for the use of it lies in the possibility of avoiding time- consuming preoperative B-ultrasonography or CT scans and performing minimally invasive surgical interventions directly.
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Objective To explore the application of laparoscopy in non-traumatic acute abdominal emergency. Methods The authors retrospectively analyzed 201 cases of emergency laparoscopy between March 1999 and May 2002. Results All the 201 patients were unequivocally diagnosed during operation. Laparoscopic operations were successfully completed in 190 cases (139 cases of acute appendicitis, 21 cases of acute cholecystitis, 19 cases of upper gastrointestinal tract perforation, 10 cases of intestinal obstruction and 1 case of common bile duct stones accompanied with acute cholecystitis), with a success rate of 94.5% (190/201). The remaining 11 patients underwent a conversion to open surgery. Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal emergency with unknown causes but also simultaneously offer a therapeutic method in at least 90% of cases.
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Objective To investigate the laparoscopic techniques in the diagnosis and treatment of acute abdominal emergency. Methods The efficacy of laparoscopic checkups and treatment in 122 consecutive patients with surgical acute abdomen admitted from January 2001 to February 2003 were analyzed retrospectively. Results Diagnosis was clarified under laparoscope in all the patients.Operations were completed under laparoscope in 117 patients,while a conversion to open surgery was required in 5 patients because of the limitation of vision scope or dense adhesion leading to difficult exposure.Two patients expired. Conclusions Laparoscopy is valuable for the differential diagnosis of surgical acute abdomen.Laparoscopic treatment can be completed in the majority of the patients,but is not advisable in certain cases.
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Objective To evaluate clinical effects of laparoscopy in acute abdominal emergency. Methods A retrospective analysis was made on clinical date of 146 cases of acute abdominal emergency from January 2001 to August 2005,including 86 cases of acute cholecystitis,45 cases of acute appendicitis,6 cases of closed abdominal trauma,5 cases of perforation of gastroduodenal ulcer,3 cases of pyosalpinx,and 1 case of adhesive intestinal obstruction. Results Out of the 146 cases,134 cases(91.8%) were successfully diagnosed and treated under laparcoscope,including 7 cases which could not be confirmatively diagnosed preoperatively.Conversions to open surgery were required in 12 cases(8.2%).No complications or fatal cases were noted.(Conclusions Laparoscopic) technique is safe,reliable,and micro-invasive in the diagnosis and treatment of acute abdominal emergency.
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Objective To assess the value of laparoscopy in the diagnosis and treatment of abdominal emergency during pregnancy.Methods Clinical data of 40 cases of abdominal emergency at 7~17 gestational weeks(mean,13.2 weeks) from June 1997 to October 2004 were retrospectively reviewed.There were 16 cases of uterine with ectopic pregnancy,3 cases of twisted ovary,5 cases of pedicel torsion of ovarian cyst,5 cases of acute cholecystitis,and 11 cases of acute appendicitis.The diagnosis and treatment were conducted under laparoscope. Results The confirmative diagnosis was clarified under laparoscope in all the cases.Except 1 case of conversion to open surgery,the operation was accomplished laparoscopically in all cases. The operation time was 25~70 min(mean,38.2 min).Surgical complications occurred in 1 case.During postoperative follow-up observations,there were 3 cases of threatened abortion,3 cases of inevitable abortion,and 1 case of premature delivery. Conclusions Laparoscopic operation is safe and effective for acute abdominal emergency during early-to-middle pregnancy.
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Acute superior mesenteric artery embolism(MAE) is uncommon in clinical, but is a severe surgical abdomen. Owing to its unfamiliarity, clinicians often made misdiagnosis. This report summarized the experience in diagnosis and surgical therapy of 25 cases of acute superior mesenteric artery embolism. The results suggested that patients with a history of heart and peripheral arterial obstructive disease encountering severe abdominal pain and hemorrhage of digestive tract, which could not be relieved by narcotics, should be considered as early signs of acute superior mesenteric artery embolism. Twenty-three were operated out of the 25 cases, among tham, 5 cases were subjected to resection of partial small intestine after removal of the embolus, 18 cases received bowel resection. In the 23 cases of MAE, 10 were cured and 13 died, the mortality in perioperative period was 57%. Early diagnosis and prompt treatment are the key to improve the therapeutic effects of AME.