The laparoscopic management of small-bowel obstruction.

BACKGROUND: Small-bowel obstruction (SBO) is a common cause of hospital admission. Our objectives were to determine outcomes of laparoscopic adhesiolysis and outline clinical parameters for its utilization.

METHODS: We reviewed medical records of patients with SBO undergoing initial laparoscopic treatment by the authors between July 1997 and March 2006. Data obtained included demographics, clinical and radiologic presentation, intraoperative outcomes, and postoperative course.

RESULTS: Forty-two patients were included for analysis. The mean age was 54.3 years, whereas the mean body mass index was 29.5 (range 20.2-46.1). Laparoscopy diagnosed the site of obstruction in all patients. Thirty-five patients (83.3%) were successfully treated laparoscopically without conversion to laparotomy. The median procedural time was lower in patients completed laparoscopically (96.3 vs 207.3 minutes, P = .006). The median postoperative stay was 6.5 days (range 1-19) in patients who were completed laparoscopically.

CONCLUSIONS: Laparoscopy is safe and feasible in the management of acute SBO in selected patients. It is an excellent diagnostic tool and therapeutic in most cases.