DIAGNOSTIC AND THERAPEUTIC ROLES OF LAPAROSCOPY IN ACUTE ABDOMEN

Abstract

In acute abdomen, laparoscopy has both diagnostic and therapeutic roles. Many studies have demonstrated an improvement in surgical decision making associated with its use; particularly, when the need for operation is uncertain. Diagnostic laparoscopy offers the potential advantage of visually excluding or confirming the diagnosis of acute intra-abdominal disorders expeditiously without performing a laparotomy. Conditions causing acute abdominal pain for which laparoscopy with or without laparoscopic surgery has a potential role including acute appendicitis, perforated peptic ulcer, acute cholecystitis, intestinal obstruction caused by band adhesions, acute diverticulitis and abdominal trauma. Laparoscopic cholecystectomy in the face of acute inflammation is safe, valid alternative to open cholecystectomy. The most important predictor of the success of attempted laparoscopic cholecystectomy in these patients is the time of surgery, being within the first 72 hours of symptoms. Delayed interval elective cholecystectomy after a "cooling off' period can not reduce the morbidity and conversion rate, moreover, it increase the total hospital stay. In patients with suspected perforated peptic ulcers, performing diagnostic laparoscopy can accurately locate the site of perforation in the majority of cases, and identifying an occasional different abnormality.