Evaluation of laparoscopy in the management of abdominal emergencies

الملخص EN

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.

Methods 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.

Results 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.

Conclusion 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