Laparoscopic treatment of small bowel obstruction.

We evaluated the reliability and immediate results of celioscopic managemen t of acute small bowel obstruction. From January 1995 to April 1998, 39 pat ients underwent a primary celioscopic procedure for small bowel obstruction . The most common etiology was post operative adhesions (34 patients). The whole operation could be carried out exclusively by celioscopy in 22 patien ts (56%). A laparotomy had to be performed in 17 patients due to: impossibi lity to identify or treat the cause of obstruction, bowel necrosis or intra operative complication (3 bowel wounds). Post operative complications were: 1 death (not directly related to the surgical procedure), 2 early recurren ces of obstruction after exclusive celioscopy, 1 evisceration after laparot omy and 1 small bowel fistula after conversion to laparotomy. Mean hospital stay was 5 days after exclusive celioscopy and 9,5 days after conversion t o laparotomy. Celioscopic management of small bowel obstruction is feasible , but it is often difficult and may be hazardous; a careful selection of pa tients must be made, based on the importance of obstruction and the type of previous abdominal surgery.