Utility and cost-savings of diagnostic laparoscopy in low-probability gunshot wounds of the abdomen.
Gunshot wounds of the abdomen are associated with a 90% or greater incidence of intra-abdominal injury, prompting many trauma centers to routinely explore these patients via laparotomy. Increasingly, diagnostic laparoscopy has been used to evaluated the abdomen to exclude peritoneal violation by the missile. Retrospective analysis of the experience at a Level I Trauma Center with 20 isolated abdominal gunshot wound patients who did not have obvious indications for laparotomy such as peritonitis or shock is detailed. Outcome and cost analysis were compared in patients who had diagnostic laparoscopy or laparotomy. Patients who underwent diagnostic laparoscopy instead of laparotomy had a 42% reduction in operative time, a 33% reduction in hospital charges, and a reduction in hospital length of stay from an average of 3.5 days to less than one day. The only operative complication noted was in a patient who underwent laparotomy. Diagnostic laparoscopy may be used in select patients to exclude significant intra-abdominal injuries following gunshot wounds of the abdomen with reduction in health care costs and morbidity.
Block
E F
EF
Department of Surgery, Louisiana State University Medical Center, Shreveport, USA.
Singh
I
I
Thompson
E
E
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000191:economics / Q000209:etiology; D000328:Adult; D003363:Cost Control; D003365:Costs and Cost Analysis; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000706:statistics & numerical data*; D007813:Laparotomy / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics*; D008145:Louisiana; D008297:Male; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers; D014948:Wounds, Gunshot / Q000175:diagnosis* / Q000191:economics