J Acute Care Surg.  2016 Apr;6(1):23-28. 10.17479/jacs.2016.6.1.23.

Laparoscopic Treatment of Intestinal Obstruction

• Hur JH
• Oh B
• Kim E
• Ahn EJ
• Park SH
• Park JM

• KMID: 2360743
• DOI: http://doi.org/10.17479/jacs.2016.6.1.23

Abstract

PURPOSE
Open adhesiolysis has been the favored approach regarding surgical management of intestinal obstruction. Following the development of laparoscopic devices and necessary surgical techniques, laparoscopic treatment of intestinal obstruction and adhesion has been tried in highly selected cases. Our study was designed to investigate laparoscopic adhesiolysis to treat intestinal obstruction.
METHODS
The clinicopathologic data and surgical outcomes of 14 patients who underwent emergency laparoscopy between January 2007 and April 2015 were retrospectively reviewed.
RESULTS
Five patients had a history of abdominal surgery, and twelve patients had adhesive intestinal obstruction. The causes of adhesive intestinal obstruction included tuberculous peritonitis, periappendiceal abscess, serosal fibrosis and chronic inflammation of intestine, gastric volvulus by fibrotic band. Two patients had non-adhesive intestinal obstruction, caused by intussusception and small bowel ulcer with stricture. The mean surgical time was 98.5 minutes, with mean blood loss of 35 ml. One case was converted to open surgery (7.1%). The mean postoperative hospital stay was 6.5 days. The mean time to oral intake was 3.4 days. There were no postoperative complications or deaths.
CONCLUSION
When the patients are selected carefully in accordance with the guidelines, in our experience laparoscopic adhesiolysis is safe and feasible.

Keyword

Intestinal obstruction; Laparoscopy; Adhesion

MeSH Terms

Abscess
Adhesives
Constriction, Pathologic
Emergencies
Fibrosis
Humans
Inflammation
Intestinal Obstruction*
Intestines
Intussusception
Laparoscopy
Length of Stay
Operative Time
Peritonitis, Tuberculous
Postoperative Complications
Retrospective Studies
Stomach Volvulus
Ulcer
Adhesives