Laparoscopic Management of Small Bowel Obstruction: Indications and Outcome

Enrique Luque-De León, Alejandro Metzger, Gregory G. Tsiotos, Richard T. Schlinkert, Michael G. Sarr

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Abstract

Our aim was to evaluate the feasibility of a laparoscopic, minimal access approach for the management of patients with small bowel obstruction. Forty patients underwent laparoscopic treatment of radiologically documented or suspected small bowel obstruction based on history and/or motility study. None had chronic abdominal or pelvic pain. The operation was completed laparoscopically in 14 patients (35%) and with laparoscopic-assisted procedures in 12 (30%); 14 (35%) required conversion to open celiotomy because of dense adhesions (precluding complete inspection or adhesiolysis), small bowel necrosis in the setting of small bowel obstruction, or neoplasia. Three iatrogenic enterotomies occurred while "running" the bowel. There were three (7%) postoperative procedure-related complications (wound infection, intra-abdominal abscess, ileus). The combined group of patients treated laparoscopically or with laparoscopic-assisted procedures had a shorter hospital stay than those converted to open celiotomy (4 ± 0.6 vs. 7 ± 0.7 days; P <0.003). At median follow-up of 12 months, 21 of 26 patients managed laparoscopically or with laparoscopic-assisted procedures remain asymptomatic; all 21 patients with an operatively confirmed site of mechanical obstruction managed by a minimal access approach remain asymptomatic. Laparoscopic treatment of small bowel obstruction is effective, leads to a shorter hospital stay, and has good long-term results. A minimal access approach to treatment of small bowel obstruction should be considered in selected patients.

Original languageEnglish (US)
Pages (from-to)132-140
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume2
Issue number2
StatePublished - Mar 1998

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ASJC Scopus subject areas

  • Surgery

Cite this

Luque-De León, E., Metzger, A., Tsiotos, G. G., Schlinkert, R. T., & Sarr, M. G. (1998). Laparoscopic Management of Small Bowel Obstruction: Indications and Outcome. Journal of Gastrointestinal Surgery, 2(2), 132-140.