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Laparoscopy for management of nontraumatic acute abdomen

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Abstract

The diagnostic and therapeutic influence of laparoscopy has been studied in 255 patients presenting with nontraumatic acute abdominal pain. Laparoscopy provided a correct diagnosis in 93% (236 of 255) of the cases, the others requiring a laparotomy. An erroneous preoperative diagnosis was corrected by laparoscopy in 50 patients (20%), which called for a change of treatment in 25 patients (10%). Seventy-three percent (186 of 255) of acute abdominal conditions were treated exclusively by laparoscopy, 23% (58 of 255) by conventional surgery, and 4% (11 of 255) by laparoscopically assisted surgery. Mortality was 2% (5 of 247) and morbidity 11% (28 of 247). We conclude that laparoscopy is a valuable tool for the general surgeon facing a patient with an acute abdomen.

Résumé

L'intérêt diagnostique et thérapeutique de la laparoscopie a été étudié chez 256 patients ayant une douleur abdominale aiguë. La laparoscopie a fourni le diagnostic exact chez 93% (236/255) des patients, les autres ayant nécessité une laparotomie. Diagnostic préopératoire a été corrigé chez 50 (20%) patients, impliquant un changement thérapeutique chez 25 (10%) patients. Soixante treize pour cent (186/255) ont été traités exclusivement par laparoscopie, 23% (58/255) par la chirurgie aidée de la laparoscopie. La mortalité a été de 2% (5/247) et la morbidité de 11% (28/247). Nous concluons que la laparoscopie est un outil utile pour le chirurgien généraliste devant un abdomen aigu.

Resumen

Se estudió el valor de la laparoscopia diagnóstica y terapéutica en 255 pacientes con dolor abdominal de origen no traumático. La laparoscopia proporcionó un diagnóstico correcto en 93% (236/255) de los casos, siendo necesaria la laparotomía en el resto. Un diagnóstico preoperatorio erróneo fue corregido por la laparoscopia en 50 pacientes (20%), lo cual significó un cambio en el plan de tratamiento en 25 pacientes (10%). Setenta y tres por ciento (186/255) de las condiciones abdominales agudas fueron tratados exclusivamente mediante laparoscopia, 23% (58/255) mediante cirugía convencional y 4% (11/255) mediante cirugía asistida por laparoscopia. La mortalidad fue 25 (5/247) y la morbilidad 11% (28/247). Nuestra conclusión es que la laparoscopia es un instrumento valioso para el cirujano general que se enfrenta con abdomen agudo.

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Authors and Affiliations

  1. Service de Chirurgie Générale, Digestive et Urologique, Hôpital St. Joseph, 6 rue de la Duchère, 6060, Gilly (Charleroi), Belgium

    B. Navez M.D., Y. d'Udekem M.D., E. Cambier M.D., C. Richir M.D., B. de Pierpont M.D. & P. Guiot M.D.

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  1. B. Navez M.D.
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  2. Y. d'Udekem M.D.
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  3. E. Cambier M.D.
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  4. C. Richir M.D.
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  5. B. de Pierpont M.D.
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  6. P. Guiot M.D.
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Navez, B., d'Udekem, Y., Cambier, E. et al. Laparoscopy for management of nontraumatic acute abdomen. World J. Surg. 19, 382–386 (1995). https://doi.org/10.1007/BF00299164

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