Application of Laparoscopy to Acute Abdominal Pain / 中国微创外科杂志

ABSTRACT

Objective To explore the efficacy of laparoscopy in acute abdominal pain. Methods From March 2002 to March 2007,306 patients with acute abdominal pain were explored and treated by laparoscopy in our hospital. The patients were diagnosed with acute appendicitis in 105 cases,unidentified abdominal pain in 34,acute cholecystitis complicated with cholecystolithiasis in 64,gastrointestinal tract perforation in 51,common bile duct stones complicated with acute cholangitis in 5,intestinal obstruction in 33,and severe acute pancreatitis in 5; 9 patients were confirmed as having trauma. Results All the 306 patients were unequivocally diagnosed during the operation. Laparoscopy was successfully completed in 275 cases,including 123 cases of appendectomy,57 cases of cholecystectomy,48 cases of gastrointestinal tract perforation neoplasty,13 cases of enterodialysis,4 cases of intestinal replacement combined with indirect hernia repair,4 cases of radical resection of the sigmoid colon with precolon anastomosis,1 case of small-incision segmental resection of the small bowel,3 cases of common bile duct resection and calculus removal,2 cases of neoplasty for right-lobe hepatorrhexis,3 cases of haemostasis for splenic rupture,5 cases of debridement and clysis and drainage for severe acute pancreatitis ,and 12 cases of laparoscopic abdominal exploration (2 cases of mesentery contusion and laceration,1 case of abdominal wall punctured wound with contusion of the greater omentum,8 case of primary peritonitis,and 1 case of abdomen-type allergic purpura). The remaining 31 patients were converted to open surgery because of difficulties in laparoscopy. The patients were followed up for 1 to 18 months,during which no one showed intra-or post-operative complications.Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal pain with unknown causes,but also treat the cases simultaneously. Moreover,it is of great help in guiding abdominal resection and making a suitable operative incision,even if the patients can not be treated by laparoscopy alone.