Laparoscopic management of adhesive acute postoperative small bowel obstruction

Laparoscopic management of postoperative acute adhesive small bowel obstruc tion (SBO) may often have clinical advantages. This prospective study inclu ded patients with postoperative acute SBO in whom sufficient intestinal dec ompression was achieved using a nasoenteric ileus tube preoperatively, but pass disorder was not improved. This study describes our experience with th e laparoscopic procedure for patients with adhesive acute SBO. The laparosc opic approach was undertaken in 24 of 51 patients admitted for acute postop erative SBO from July 1994 through June 2000; it was performed successfully in 20 patients (83%), and four cases were converted to open surgery (17%) because of strong adhesions. In four patients with gallstones and inguinal hernia, laparoscopic surgery (cholecystectomy, hernioplasty) was performed simultaneously. There was no mortality and low morbidity (4.1%). The group of patients treated laparoscopically had a shorter hospital stay than the c onventional open group (12 versus 21 days; p < 0.05). At the median follow- up of 84 months, 21 of the 22 patients who had received laparoscopic proced ure remained asymptomatic. Laparoscopic treatment was effective, involved a shorter hospital stay and has shown good long-term results for most patien ts with adhesive acute SBO.