Selective Laparoscopic Management of Adhesive Small Bowel Obstruction Using CT Guidance

• Published in: The American surgeon Vol. 75; no. 3; pp. 227 - 231
• Main Authors: IN KYU LEE, DO HYOUNG KIM, LEE GORDEN, D, YOON SUK LEE, SEUNG EUN JUNG, SEONG TAEK OH, KIM, Jun-Gi, HAE MYUNG JEON, EUNG KOOK KIM, SUK KYUN CHANG
• Format: Journal Article
• Language: English
• Published: Atlanta, GA Southeastern Surgical Congress 01.03.2009; SAGE PUBLICATIONS, INC
• Subjects: Biological and medical sciences; Cameras; Chi-Square Distribution; Digestive system. Abdomen; Endoscopy; Female; General aspects; Hospitals; Humans; Intestinal Obstruction - diagnostic imaging; Intestinal Obstruction - surgery; Intestine, Small; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy - methods; Male; Medical sciences; Middle Aged; Patients; Postoperative Complications - diagnostic imaging; Postoperative Complications - surgery; Radiography, Interventional; Retrospective Studies; Studies; Surgery; Tissue Adhesions - diagnostic imaging; Tissue Adhesions - surgery; Tomography, X-Ray Computed; Treatment Outcome; Radiodiagnosis; Laparoscopy; Small intestine; Obstruction; Guidance; Medicine; Clinical management; Treatment; Surgery; Medical imagery; Computerized axial tomography; Endoscopy; Adhesive
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313480907500308

Small bowel obstruction after intra-abdominal surgery is a common cause of morbidity necessitating reoperation. The aim of this study was to determine the feasibility of and indications for laparoscopic surgery for acute adhesive small bowel obstruction (AASBO). We conducted a retrospective review of all patients with AASBO who underwent laparoscopic adhesiolysis at a major university medical center. Laparoscopic treatment was performed successfully in 16 patients, and conventional treatment was performed in 13 patients. The rate of conversion from laparoscopic to open was 16.7 per cent. In 15 of 16 total patients who underwent laparoscopic surgery, laparoscopic bandlysis was performed and one patient underwent laparoscopic adhesiolysis. Laparoscopic surgery was performed successfully in nine who had a single adhesive band demonstrated on an abdominal CT, and conventional surgery was performed in all 10 patients without a single adhesive band identified radiographically. Abdominal CT scans facilitate the selection of operative approach for AASBO based on preoperative identification of the obstruction site. Laparoscopic adhesiolysis is a safe and effective treatment modality for patients with AASBO with a single band or single transition zone identified by preoperative imaging.