Laparoscopic versus open surgical management of small bowel obstruction: an analysis of clinical outcomes.

Abstract

Laparotomy is the standard surgical approach for treatment of small bowel obstruction (SBO). Laparoscopic management could be beneficial in terms of less complications and shorter hospital stay. As the minimal invasive approach is gaining more acceptances in the treatment of SBO, there is an increased need of studies to analyze outcomes. The aim of the present study was to compare the short-term clinical outcomes of laparoscopy versus laparotomy in the surgical management of non-bariatric, non-malignant SBO. A retrospective analysis of patients treated for SBO during 2010-2015 was made by a comprehensive search of medical records. A matched-pair review was performed on patients managed surgically for non-bariatric, non-malignant SBO at Danderyd University Hospital, Stockholm, Sweden. Completed laparoscopic surgeries were matched against patients treated with open surgery. Laparoscopy for SBO was initiated in 71 patients. Conversion to open surgery was performed in 42%. Results from the matched-pair analysis showed that post-operative length of stay was reduced by 60% (P<0.001) in the laparoscopic cohort. Additionally, less major complications were reported and duration of surgery was reduced by 50% (P<0.001). Laparoscopic management is a safe and feasible alternative to laparotomy. Hospital length of stay was significantly shorter and morbidity rate acceptable.