Laparoscopic Management of Bowel Obstruction, the All Inclusive Approach, Improves Outcomes.

Christopher W Salzmann, MD, Morris E Franklin, MD FACS, Karla Russek, MD. Texas Endosurgery Institute


Background: Multiple series on laparoscopic management of Bowel obstruction have been published. Most are limited to likely cases of adhesive Small Bowel Obstruction and exclude patients with hernias and/or Colon Obstruction. We present our series on the “all inclusive approach” to laparoscopic treatment of bowel obstruction.

Methods: From 1991 to 2010, 448 patients underwent laparoscopy for Bowel Obstruction. Results: Laparoscopic management was successful in 74.5%. There were 62 enterotomies (13.8%). Mean length of stay was 10.4 days. Mortality was 1.7%. Significant differences were found between the Laparoscopic and Converted patients in enterotomies (6.4% vs 40%), Mean ASA score (2.47 vs. 2.94), Blood loss (49.183 vs. 177.35 cc), Length of surgery (94 vs. 166 min.), length of stay 9.485 and 14.714 (p value 0.008) and in the Nonenterotomy and Enterotomy length of surgery (94 vs. 149 min.) and Blood loss (64 vs. 127cc). Linear regression showed a relation between ASA score and Length of Stay (p value 0.0001).

Conclusion: Bowel Obstruction can be managed by laparoscopy in 74.5% of cases. Conversion is associated with a significant increase in blood loss, operating time, a greater number of enterotomies and increased length of stay, with the latter being related to patient co-morbidites.

Session Number: Poster – Poster Presentations
Program Number: P207
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