Selective laparoscopic management of adhesive small bowel obstruction using CT guidance.
Small bowel obstruction after intra-abdominal surgery is a common cause of morbidity necessitating reoperation. The aim of this study was to determine the feasibility of and indications for laparoscopic surgery for acute adhesive small bowel obstruction (AASBO). We conducted a retrospective review of all patients with AASBO who underwent laparoscopic adhesiolysis at a major university medical center. Laparoscopic treatment was performed successfully in 16 patients, and conventional treatment was performed in 13 patients. The rate of conversion from laparoscopic to open was 16.7 per cent. In 15 of 16 total patients who underwent laparoscopic surgery, laparoscopic bandlysis was performed and one patient underwent laparoscopic adhesiolysis. Laparoscopic surgery was performed successfully in nine who had a single adhesive band demonstrated on an abdominal CT, and conventional surgery was performed in all 10 patients without a single adhesive band identified radiographically. Abdominal CT scans facilitate the selection of operative approach for AASBO based on preoperative identification of the obstruction site. Laparoscopic adhesiolysis is a safe and effective treatment modality for patients with AASBO with a single band or single transition zone identified by preoperative imaging.
Lee
In Kyu
IK
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmcgslee@catholic.ac.kr
Kim
Do Hyoung
DH
Gorden
D Lee
DL
Lee
Yoon Suk
YS
Jung
Seung Eun
SE
Oh
Seong Taek
ST
Kim
Jun-Gi
JG
Jeon
Hae Myung
HM
Kim
Eung Kook
EK
Chang
Suk Kyun
SK
D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D007421:Intestine, Small; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome