title: To Study the Aetiological Factors and Outcomes of Urgent Re-Laparotomy in Himalayan Hospital.
abstract: BACKGROUND
  Treatment of a number of complications that occur after abdominal surgeries may require that Urgent Relaparotomy (UR), the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing URs, their outcomes and factors that affect mortality.
  
  
  METHODS
  Observational, Prospective Study. The study included all the patients who underwent urgent re-laparotomy following laparotomy (emergency, elective) in Himalayan Hospital from 01.01.2013 to 01.06.2014 and excluded those who underwent laparotomy outside.
  
  
  RESULTS
  UR was performed for 40 out of 1050 patients (4.2%), of which males were 25 and females 15. The average time interval between the index laparotomy and urgent re-exploration was 6.4 days. The most common reason for mortality was multi organ failure with septic shock. The most common criteria for re-exploration were anastomotic leak (n=13), followed by pyoperitoneum (n=11) and persistent peritonitis (n=6). Comparing the index surgery, lower gastro-intestinal procedures were most usually involved (n=21, 47.7%), followed by hepato-pancreato-biliary surgeries (n=8, 18.2%). There were 6 cases of upper gastro-intestinal surgeries that reexplored (13.6%).
  
  
  CONCLUSIONS
  UR that is performed following complicated abdominal surgeries has high mortality rates. In particular, they have higher mortality rates following GIS surgeries or when infectious complications occur.
authors.forename: Arunav
authors.initials: A
authors.lastname: Sharma
authors.forename: Shantanu Kumar
authors.initials: SK
authors.lastname: Sahu
authors.forename: Mayank
authors.initials: M
authors.lastname: Nautiyal
authors.forename: Navneet
authors.initials: N
authors.lastname: Jain
mesh_terms: D000006:Abdomen, Acute / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000328:Adult; D057868:Anastomotic Leak / Q000453:epidemiology; D004630:Emergencies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007194:India; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007813:Laparotomy / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology; D009390:Nepal / Q000453:epidemiology; D010538:Peritonitis / Q000453:epidemiology; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology; D015996:Survival Rate