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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2006

01-01-2006

Laparoscopy for abdominal emergencies

Evidence-based guidelines of the European Association for Endoscopic Surgery

Authors: S. Sauerland, F. Agresta, R. Bergamaschi, G. Borzellino, A. Budzynski, G. Champault, A. Fingerhut, A. Isla, M. Johansson, P. Lundorff, B. Navez, S. Saad, E. A. M. Neugebauer

Published in: Surgical Endoscopy | Issue 1/2006

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Abstract

Background

Emergency laparoscopic exploration can be used to identify the causative pathology of acute abdominal pain. Laparoscopic surgery also allows treatment of many intraabdominal disorders. This report was prepared to describe the effectiveness of laparoscopic surgery compared to laparotomy or nonoperative treatment.

Methods

A panel of European experts in abdominal and gynecological surgery was assembled and participated in a consensus conference using Delphi methods. The aim was to develop evidence-based recommendations for the most common diseases that may cause acute abdominal pain.

Recommendations

Laparoscopic surgery was found to be clearly superior for patients with a presumable diagnosis of perforated peptic ulcer, acute cholecystitis, appendicitis, or pelvic inflammatory disease. In the emergency setting, laparoscopy is of unclear or limited value if adhesive bowel obstruction, acute diverticulitis, nonbiliary pancreatitis, hernia incarceration, or mesenteric ischemia are suspected. In stable patients with acute abdominal pain, noninvasive diagnostics should be fully exhausted before considering explorative surgery. However, diagnostic laparoscopy may be useful if no diagnosis can be found by conventional diagnostics. More clinical data are needed on the use of laparoscopy after blunt or penetrating trauma of the abdomen.

Conclusions

Due to diagnostic and therapeutic advantages, laparoscopic surgery is useful for the majority of conditions underlying acute abdominal pain, but noninvasive diagnostic aids should be exhausted first. Depending on symptom severity, laparoscopy should be advocated if routine diagnostic procedures have failed to yield results.
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Metadata
Title
Laparoscopy for abdominal emergencies
Evidence-based guidelines of the European Association for Endoscopic Surgery
Authors
S. Sauerland
F. Agresta
R. Bergamaschi
G. Borzellino
A. Budzynski
G. Champault
A. Fingerhut
A. Isla
M. Johansson
P. Lundorff
B. Navez
S. Saad
E. A. M. Neugebauer
Publication date
01-01-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 1/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0564-0

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