Evaluation of laparoscopy in the management of abdominal emergencies

ABSTRACT

Laparoscopy has rapidly emerged as the preferred surgical approach for the management of abdominal emergencies. It allows for a correct diagnosis and proper treatment. The main aim of this study was to evaluate the role of laparoscopy as a major diagnostic and therapeutic tool for the management of patients with abdominal emergencies and to find a less invasive diagnostic approach. Eighty patients with acute abdominal pain presented to the Department of surgery of Al-Azhar University [Bab El Shearia and Al Husein] hospitals during October 2009 to September 2011 were included in the study. They were divided into two groups traumatic [40 patients] and nontraumatic [40 patients]. Their ages ranged between 14 and 65 years [mean= 39.5 years]; 49 patients were males and 31 patients were females. Complete clinical data were obtained. All patients underwent a routine preoperative workup. Laparoscopy was performed for all patients within 24 h of admission. The procedure was carried out under general anesthesia. Both open and closed pneumoperitoneum techniques were practiced. Diagnostic laparoscopy was beneficial in 79 patients [98.5%]. Of them, 42 [52.5%] patients underwent successful therapeutic procedures with laparoscopy 28 male patients [17 nontraumatic and 11 traumatic] and 14 female patients [12 nontraumatic and two traumatic]. Conversion to therapeutic laparotomy was done for 12 patients [15%]. In this study, the mean postoperative hospital stay after laparoscopy was 2.1 days and 4.55 days after laparotomy. Wound infections occurred in 2.5% of patients. Early laparoscopic intervention for abdominal emergencies is as safe and effective as conventional surgery. It results in minor trauma, helps avoid extensive preoperative studies or delays in operative intervention, has a rapid postoperative recovery, and reduces morbidity. Such features make laparoscopy an attractive alternative to open surgery in the management of abdominal emergencies