[Video laparoscopy in abdominal emergencies].
BACKGROUND
Personal experience about the use of video laparoscopy (VL) in abdominal emergencies is reported.


METHODS



METHODS
retrospective evaluation of patients observed in the last years.


METHODS
General Surgery I. Policlinico, University of Palermo.


METHODS
61 VL have been performed: 30 acute appendicitis, 21 acute cholecystitis, 4 perforated peptic ulcer, 1 haemoperitoneum by haemorrhaged luteal corpus, 2 pelvic inflammatory disease (PID), 1 terminal ileitis, 1 choledochal perforation after ERCP and 1 bleeding after CVL.


METHODS
the following interventions have been performed: 22 VL appendectomy, 8 VL-assisted appendectomy, 21 VL cholecystectomy, 1 VL duodenal suture, 3 minilaparotomic duodenal suture, 2 prophylactic VL-assisted appendectomy, in 1 patient with terminal ileitis and in 1 PID, 1 VL partial ovarian resection. In the case with choledochal perforation during ERCP a traditional cholecystectomy was performed with an outer biliary drainage. In the patient with bleeding after CVL the spontaneous haemostasis seen during VL was confirmed by laparotomy performed to exclude baro-haemostasis and to prevent from legal motivation. The procedure was only diagnostic in 1 patient with PID.


METHODS
the diagnostic and therapeutic value, versus traditional surgery have been valued.


RESULTS
VL is useful both for a correct diagnosis and to lead a laparotomy if necessary, allowing an adequate peritoneal exploration and toilet without large incisions; the operation is therefore, in any case, less invasive.


CONCLUSIONS
In our experience the usefulness of VL is clear in the suspect of acute appendicitis, acute cholecystitis, perforated peptic ulcer, haemoperitoneum and when diagnosis is not sure and in all other situations in which correct preoperative diagnosis is impossible. So this procedure is useful to make easy a correct diagnosis and to surgical treatment.
Siragusa
G
G
Cattedra di Chirurgia Generale I, Università degli Studi, Palermo.
Gelarda
E
E
Epifanio
E
E
Geraci
F
F
Geraci
G
G
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D014741:Video Recording
La videolaparoscopia nelle urgenze addominali.