Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIHan-tuo , RENZhi-gang , LIMing-hui , CHENJing-hua , WUXiao-feng , FEIKe-ping

Department of General Surgery, Changping District Hospital in Beijing, Beijing 102200, China;

Corresponding?author：

LIHan-tuo, Email: lihantuo@sina.com

Keywords：

Laparoscopy; Acute abdomen; Diagnosis; Treatment

DOI：

10.7507/1007-9424.20150089

Video：

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Objective To investigate the feasibility of laparoscopy in the diagnosis and treatment of acute abdomen. Methods The clinical data of 81 patients with acute abdomen treated in our hospital from January 2012 to December 2013 were retrospectively analyzed. Results Of the 81 patients with acute abdomen, there were 38 cases of acute appendicitis, 15 cases of gastric perforation, 10 cases of duodenal ulcer perforation, 10 cases of acute cholecystitis, 1 case of mesenteric artery embolism, 2 cases of internal hernias, 2 cases of ileocecal tumor, 2 cases of sigmoid colon rupture, 1 case of intestinal adhesion. The 81 cases were treated by laparoscopy, including 79 cases (97.5%) were clearly diagnosed; 73 cases were succeeded by laparoscopy, and 8 cases converted to laparotomy. The operation time were 35-191 minutes, with an average of 76 minutes; the intraoperative blood loss were 20-130 mL, with an average of 43 mL; the postoperative hospital stay were 3-13 days, with an average of 5.6 days. Seventy-six patients received followed-up for 2-24 months, and the median time were 14 months, no special complications occurred during follow-up period, but 1 case of ileocecal tumor suffered from lung metastases in 12 months after operation. Conclusions Laparoscopy can be used in the preferred way of diagnosis and treatment of acute abdomen.

Citation： LIHan-tuo, RENZhi-gang, LIMing-hui, CHENJing-hua, WUXiao-feng, FEIKe-ping. Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 335-338. doi: 10.7507/1007-9424.20150089 Copy

1.	?Richardson WS, Stefanidis D, Chang L, et al. The role of diagnostic laparoscopy for acute abdominal conditions:an evidence-based review. Surg Endosc, 2009, 23(9):2073-2077.
2.	馬云濤, 蘇河, 王斌, 等. 腹腔鏡技術在外科急腹癥中的應用. 中國微創外科雜志, 2009, 15(7):599-602.
3.	Hori Y; SAGES Guidelines Committee. Diagnostic laparoscopy guidelines:this guideline was prepared by the SAGES Guidelines Committee and reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), November 2007. Surg Endosc, 2008, 22(5):1353-1383.
4.	石美鑫. 實用外科學. 北京:人民衛生出版社, 2002:755, 921.
5.	楊昌毅, 陳志山, 洪黎清, 等. 腹腔鏡技術在急腹癥診治中的應用. 中國實用醫刊, 2014, 41(20): 40-41.
6.	戢運俊, 孫衛兵, 和梅亮, 等. 腹腔鏡技術在急腹癥1 035例診治中的應用. 中國臨床新醫學, 2013, 6(7): 689-691.
7.	葉春. 腹腔鏡闌尾切除術40例治療體會. 中國普外基礎與臨床雜志, 2012, 19(5):521.
8.	劉長昆, 王建, 于世良, 等. 腹腔鏡與開腹手術治療老年急性闌尾炎患者的療效對比分析. 中國普外基礎與臨床雜志, 2011, 18(7):766-768.
9.	胡斌, 鄧劍, 趙葉平, 等. 腹腔鏡技術在急腹癥診治中的應用體會. 中國普外基礎與臨床雜志, 2013, 20(1): 85-87.
10.	翟文裕. 腹腔鏡技術在急性彌漫性腹膜炎治療過程中的療效觀察. 新疆醫學, 2013, 43(3):109-110.
11.	宋賢超. 腹腔鏡在普外科急腹癥治療中的應用分析. 中國醫藥指南, 2012, 10(14):100-101.
12.	亓玉忠, 王國斌. 腹腔鏡闌尾切除術700例分析. 腹腔鏡外科雜志, 2008, 13(5):416-417.
13.	李伯琴. 腹腔鏡上消化道潰瘍穿孔修補手術護理配合. 現代醫藥衛生, 2009, 25(16):2528-2529.
14.	余育暉, 錢章選, 郭慶渠. 腹腔鏡技術在非創傷性外科急腹癥中治療的體會. 浙江創傷外科, 2013, 18(5):686-687.
15.	馬雪平, 趙國發, 崔猛勝. 老年人腹腔鏡膽囊切除術創傷反應臨床觀察. 中華消化內鏡雜志, 2003, 20(2):128-129.
16.	鄧進巍, 張衛華, 劉燕. 腹腔鏡在外科急腹癥中的應用價值. 腹腔鏡外科雜志, 2010, 15(6):447-449.
17.	李國庫, 張云. 腹腔鏡技術在急腹癥中的應用. 中國現代藥物應用, 2010, 4(12):89-90.
18.	Pezzolla A, Milella M, Lattarulo S, et al. Laparoscopic appendectomy.Our experience. Ann Ital Chir, 2012, 83(3):253-257.
19.	Markar SR, Venkat-Raman V, Ho A, et al. Laparoscopic versus openappendicectomy in obese patients. Int J Surg, 2011, 9(6):451-455.
20.	Sahm M, Pross M, Lippert H. Acute appendicitis-changes in epidemiology, diagnosis and therapy. Zentralbl Chir, 2011, 136(1):18-24.
21.	張大明, 李建軍. 腹腔鏡手術治療粘連性腸梗阻的手術技巧. 腹腔鏡外科雜志, 2012, 17(1):48-49.
22.	秦立國, 畢英謙. 急性闌尾炎行腹腔鏡手術及開腹手術60例臨床分析. 中華全科醫學, 2012, 10(9):1400-1401.
23.	肖志剛, 黃忠誠, 劉升鋒, 等. 腹腔鏡技術在普外科急腹癥診治中的應用. 中國內鏡雜志, 2011, 17(6):653-654.
24.	胡毅, 高文彪, 楊旭, 等. 腹腔鏡在非創傷性急腹癥中的臨床應用價值探討. 中國實用醫藥, 2012, 7(20):12-13.
25.	Durai R, Razvi A, Uzkalnis A, et al. Duodenal ulcer perforation:a district hospital experience. Acta Chir Belg, 2011, 111(1):23-25.

1. ?Richardson WS, Stefanidis D, Chang L, et al. The role of diagnostic laparoscopy for acute abdominal conditions:an evidence-based review. Surg Endosc, 2009, 23(9):2073-2077.
2. 馬云濤, 蘇河, 王斌, 等. 腹腔鏡技術在外科急腹癥中的應用. 中國微創外科雜志, 2009, 15(7):599-602.
3. Hori Y; SAGES Guidelines Committee. Diagnostic laparoscopy guidelines:this guideline was prepared by the SAGES Guidelines Committee and reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), November 2007. Surg Endosc, 2008, 22(5):1353-1383.
4. 石美鑫. 實用外科學. 北京:人民衛生出版社, 2002:755, 921.
5. 楊昌毅, 陳志山, 洪黎清, 等. 腹腔鏡技術在急腹癥診治中的應用. 中國實用醫刊, 2014, 41(20): 40-41.
6. 戢運俊, 孫衛兵, 和梅亮, 等. 腹腔鏡技術在急腹癥1 035例診治中的應用. 中國臨床新醫學, 2013, 6(7): 689-691.
7. 葉春. 腹腔鏡闌尾切除術40例治療體會. 中國普外基礎與臨床雜志, 2012, 19(5):521.
8. 劉長昆, 王建, 于世良, 等. 腹腔鏡與開腹手術治療老年急性闌尾炎患者的療效對比分析. 中國普外基礎與臨床雜志, 2011, 18(7):766-768.
9. 胡斌, 鄧劍, 趙葉平, 等. 腹腔鏡技術在急腹癥診治中的應用體會. 中國普外基礎與臨床雜志, 2013, 20(1): 85-87.
10. 翟文裕. 腹腔鏡技術在急性彌漫性腹膜炎治療過程中的療效觀察. 新疆醫學, 2013, 43(3):109-110.
11. 宋賢超. 腹腔鏡在普外科急腹癥治療中的應用分析. 中國醫藥指南, 2012, 10(14):100-101.
12. 亓玉忠, 王國斌. 腹腔鏡闌尾切除術700例分析. 腹腔鏡外科雜志, 2008, 13(5):416-417.
13. 李伯琴. 腹腔鏡上消化道潰瘍穿孔修補手術護理配合. 現代醫藥衛生, 2009, 25(16):2528-2529.
14. 余育暉, 錢章選, 郭慶渠. 腹腔鏡技術在非創傷性外科急腹癥中治療的體會. 浙江創傷外科, 2013, 18(5):686-687.
15. 馬雪平, 趙國發, 崔猛勝. 老年人腹腔鏡膽囊切除術創傷反應臨床觀察. 中華消化內鏡雜志, 2003, 20(2):128-129.
16. 鄧進巍, 張衛華, 劉燕. 腹腔鏡在外科急腹癥中的應用價值. 腹腔鏡外科雜志, 2010, 15(6):447-449.
17. 李國庫, 張云. 腹腔鏡技術在急腹癥中的應用. 中國現代藥物應用, 2010, 4(12):89-90.
18. Pezzolla A, Milella M, Lattarulo S, et al. Laparoscopic appendectomy.Our experience. Ann Ital Chir, 2012, 83(3):253-257.
19. Markar SR, Venkat-Raman V, Ho A, et al. Laparoscopic versus openappendicectomy in obese patients. Int J Surg, 2011, 9(6):451-455.
20. Sahm M, Pross M, Lippert H. Acute appendicitis-changes in epidemiology, diagnosis and therapy. Zentralbl Chir, 2011, 136(1):18-24.
21. 張大明, 李建軍. 腹腔鏡手術治療粘連性腸梗阻的手術技巧. 腹腔鏡外科雜志, 2012, 17(1):48-49.
22. 秦立國, 畢英謙. 急性闌尾炎行腹腔鏡手術及開腹手術60例臨床分析. 中華全科醫學, 2012, 10(9):1400-1401.
23. 肖志剛, 黃忠誠, 劉升鋒, 等. 腹腔鏡技術在普外科急腹癥診治中的應用. 中國內鏡雜志, 2011, 17(6):653-654.
24. 胡毅, 高文彪, 楊旭, 等. 腹腔鏡在非創傷性急腹癥中的臨床應用價值探討. 中國實用醫藥, 2012, 7(20):12-13.
25. Durai R, Razvi A, Uzkalnis A, et al. Duodenal ulcer perforation:a district hospital experience. Acta Chir Belg, 2011, 111(1):23-25.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen

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