title: The role of laparoscopy in penetrating abdominal stab wounds.
abstract: The role of diagnostic laparoscopy (DL) in abdominal stab wounds (ASWs) is not clearly defined. We hypothesized that peritoneal penetration (PP) during DL was a valid indication to convert to an exploratory laparotomy (EL). Retrospective review of hemodynamically stable ASWs requiring operation. A total of 161 patients with ASWs were identified, with 36 of 92 patients (39.1%) undergoing DL converted to EL. All 36 patients had PP; 20 of 36 (55.6%) ELs were therapeutic (TL). The number of nontherapeutic laparotomies (NTLs) prevented was 56 (60.9%). Five of 92 patients had PP on DL but did not undergo EL. Twenty-four of 69 patients who underwent initial EL had an NTL (34.8%). If this group had undergone an initial DL, and PP was used to determine need for EL, the number of NTLs would have been reduced to 10 (14.5%), a 58.3% reduction. Evidence of PP during DL is a reasonable indicator to determine the need for EL and reduce the number of NTLs.
authors.affiliation: Department of Surgery, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, USA. racherry@psu.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cherry
authors.forename: Soumitra R
authors.initials: SR
authors.lastname: Eachempati
authors.forename: Lynn J
authors.initials: LJ
authors.lastname: Hydo
authors.forename: Philip S
authors.initials: PS
authors.lastname: Barie
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D003657:Decision Making; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy; D010537:Peritoneum / Q000293:injuries*; D011237:Predictive Value of Tests; D015599:Trauma Severity Indices; D014951:Wounds, Stab / Q000175:diagnosis* / Q000601:surgery