Laparoscopy in the management of acute abdominal pain

Abstract

A survey of all general surgeons in one regional health authority has shown that despite the increase in laparoscopic surgery following the introduction of laparoscopic cholecystectomy, laparoscopy was used in the management of acute abdominal pain by 28% of consultants and only 10% of trainee surgeons. In a retrospective study of 316 patients undergoing open appendicectomy the histological appearance of the appendix was normal in 60 (19%). In a non-randomized prospective study only 13 of 30 patients laparo-scoped who were due to undergo open appendicectomy had acute appendicitis. Patients undergoing diagnostic laparoscopy and laparoscopic appendicectomy had a shorter post-operative hospital stay (1.7 ± 0.2 days) compared to those undergoing open appendicectomy (2.9 ± 0.2 days), which is highly significant (P < 0.0001). In the management of acute abdominal pain laparoscopy can significantly reduce unnecessary operative intervention and allow earlier discharge from hospital and return to full mobility.

Key Words:

• abdominal pain
• laparoscopy
• diagnosis
• appendicectomy