The use of laparoscopy in abdominal emergencies.
BACKGROUND
The purpose of this article is to describe our experience using laparoscopy in the management of emergent and acute abdominal conditions.


METHODS
Between March 1997 and November 2001, 277 consecutive minimally invasive procedures were performed for various nontrauma surgical emergencies. The indications for operation were nonspecific abdominal pain in 129 cases (46%), peritonitis in 64 cases (23%), small bowel obstruction in 52 cases (19%), complications after previous surgery or invasive procedures in 24 cases (9%), and sepsis of unknown origin in 8 cases (3%).


RESULTS
Laparoscopy obtained a correct diagnosis in 98.6% of the cases. In 207 patients (75%), the procedure was completed laparoscopically. An additional 35 patients (12.5%) required a target incision. The remaining 35 patients (12.5%) underwent formal laparotomy. The morbidity rate was 5.8%. No laparoscopy-related mortality was observed.


CONCLUSIONS
For patients with abdominal emergencies, the laparoscopic approach provides diagnostic accuracy and therapeutic options, avoids extensive preoperative studies, averts delays in operative intervention, and appears to reduce morbidity.
Department Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, POB 151 Beer Sheva, Israel 84101. borkirsh@bgumail.bgu.ac.il
B
B
Kirshtein
A
A
Roy-Shapira
L
L
Lantsberg
S
S
Mandel
E
E
Avinoach
S
S
Mizrahi
D000005:Abdomen; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged