EMERGENCY LAPAROSCOPY - A 20-YEAR EXPERIE NCE

We revised 7988 laparoscopies over twenty years. Three hundred and nin ety three were urgent laparoscopies: 325 patients with acute spontaneo us abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is ma de in patients with, both spontaneous and traumatic acute abdomen, whe n diagnosis is not made in 8 hours with the usual clinical and imaging methods. Acute diffuse peritonitis was the commonest finding in the f irst group (21%) and splenic rupture in the traumatic group (34%). The re were two severe complications (0.5%): pulmonary oedema in a patient with miocardial disease and a respiratory failure in a old patient, w hich were resolved. We had two deaths related to laparoscopic diagnosi s: massive mesenteric thrombosis and fecal peritonitis. There are few contraindications and tolerance is very good. This study shows a sensi tivity of 98%, a specificity of 90%, a predictive positive value great er than 98% and a negative predictive value of 100%. In summary, the p resent study demonstrates that emergency laparoscopy is a effective di agnostic method in acute abdominal pain of uncertain aetiology.