title: Role of laparoscopy in the management of visceral injuries following abdominal stab wounds.
abstract: BACKGROUND
  Laparoscopy offers several advantages in the treatment of abdominal stab wounds. In this paper, we report our experience during 2004, where hemodynamically stable patients with stab wounds were managed laparoscopically.
  
  
  METHODS
  Between January and December 2004, 8 hemodynamically stable patients (7 men, 1 woman) underwent laparoscopy for anterior abdominal stab wounds. Median age was 28.5 years (range, 17-55). All patients underwent an abdominal computed tomography (CT) prior to the laparoscopy.
  
  
  RESULTS
  Exploration of the wound under aseptic conditions, carried out as a part of the physical examination, confirmed peritoneal penetration in 7 of the 8 cases. Abdominal CT revealed positive findings in 7 (87.5%) cases. Laparoscopy was performed after a median time of 60 minutes (range 30-90). Laparoscopic exploration evidenced peritoneal penetration in 100% of the cases and visceral lesions in 87.5% of the cases. All visceral injuries were managed laparoscopically. Median operative time was 135 minutes (range, 45-200). Operative mortality was 0% and early morbidity was 12.5%. Median hospital stay was 5 days (range, 1-11). After a median follow-up of 12 months (range, 1-28), 1 patient complained of persistent chest pain and a ventral hernia at the site of the abdominal stab wound was diagnosed in another patient.
  
  
  CONCLUSIONS
  Laparoscopy should be included in management algorithms in patients with anterior abdominal stab wounds who are hemodynamically stable. In addition to its diagnostic ability, this study demonstrates that laparoscopy can be an effective management modality with minimal morbidity and no mortality.
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium. giovanni@dapri.net
authors.forename: Giovanni
authors.initials: G
authors.lastname: Dapri
authors.forename: Jacques
authors.initials: J
authors.lastname: Himpens
authors.forename: David
authors.initials: D
authors.lastname: Lipski
authors.forename: Jean
authors.initials: J
authors.lastname: Bruyns
authors.forename: Elie
authors.initials: E
authors.lastname: Capelluto
authors.forename: Etienne
authors.initials: E
authors.lastname: Stevens
authors.forename: Alain
authors.initials: A
authors.lastname: Roman
authors.forename: Bernard
authors.initials: B
authors.lastname: Hainaux
authors.forename: Olivier
authors.initials: O
authors.lastname: Germay
authors.forename: Guy-Bernard
authors.initials: GB
authors.lastname: Cadière
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014781:Viscera / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000601:surgery*