Laparoscopic management of intra-abdominal infections: Systematic review of the literature.
OBJECTIVE
To investigate the role of laparoscopy in diagnosis and treatment of intra abdominal infections.


METHODS
A systematic review of the literature was performed including studies where intra abdominal infections were treated laparoscopically.


RESULTS
Early laparoscopic approaches have become the standard surgical technique for treating acute cholecystitis. The laparoscopic appendectomy has been demonstrated to be superior to open surgery in acute appendicitis. In the event of diverticulitis, laparoscopic resections have proven to be safe and effective procedures for experienced laparoscopic surgeons and may be performed without adversely affecting morbidity and mortality rates. However laparoscopic resection has not been accepted by the medical community as the primary treatment of choice. In high-risk patients, laparoscopic approach may be used for exploration or peritoneal lavage and drainage. The successful laparoscopic repair of perforated peptic ulcers for experienced surgeons, is demonstrated to be safe and effective. Regarding small bowel perforations, comparative studies contrasting open and laparoscopic surgeries have not yet been conducted. Successful laparoscopic resections addressing iatrogenic colonic perforation have been reported despite a lack of literature-based evidence supporting such procedures. In post-operative infections, laparoscopic approaches may be useful in preventing diagnostic delay and controlling the source.


CONCLUSIONS
Laparoscopy has a good diagnostic accuracy and enables to better identify the causative pathology; laparoscopy may be recommended for the treatment of many intra-abdominal infections.
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Federico
F
Coccolini
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Cristian
C
Tranà
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Massimo
M
Sartelli
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Fausto
F
Catena
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Salomone
S
Di Saverio
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Roberto
R
Manfredi
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Giulia
G
Montori
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Marco
M
Ceresoli
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Chiara
C
Falcone
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Luca
L
Ansaloni
Appendicitis; Cholecystitis; Diverticulitis; Infection; Laparoscopy; Perforation; Post-operative; Pregnancy; Treatment