Purpose: We assessed the feasibility and efficacy of a laparoscopic approach in surgically managing various conditions of the acute abdomen. Methods: This report presents preliminary data from our ongoing prospective study. Sixty patients
underwent
a
diagnostic or a therapeutic laparoscopy for acute or subacute abdominal conditions between July 1997 and September 1998. Results: Conditions were classified into trauma (n=8), peritonitis (n=41), and obstruction (n=11). Trauma included 5 blunt (2
small
bowel perforations, 1 spleen rupture, 2 mesenteric ruptures) and 3 stab injuries. Peritonitis included 23 duodenal ulcer perforations, 10 acute cholecytitis/empyema, 3 colon perforations, 1 tuberculous peritonitis, 1 ectopic pregnancy, 1 ruptured
corpus
luteum, 1 appendicitis, and 1 ruptured liver abscess. Obstruction included 5 intussusceptions (4 chilren, 1 adult), 2 intestinal adhesions; and 4 congenital hypertropic pyloric stenoses. Among the 54 cases of therapeutic laparoscopy, 9 cases were
converted during the procedure (conversion rate: 16.7%). There were 2 intraoperative (bowel perforation) and 4 postoperative (1 subphrenic abscess, 1 incomplete adhesiolysis, 1 port site hernia, 1 port-site seroma) complications. Conclusion: Our
preliminary data may justify further clinical study to clarify the role of laparoscopy in managing acute or subacute abdominal conditions.
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