Outcomes of laparoscopic management of acute small bowel obstruction: a 7-year experience of 110 consecutive cases with various etiologies.

Abstract

Laparoscopic surgery is emerging as an alternative to open surgery for treating acute small bowel obstruction (SBO). While postoperative adhesion is the most frequent etiology, the optimum treatment for all types of SBO needs to be evaluated. A retrospective review was performed of 110 consecutive patients who underwent laparoscopic surgery at our institution between 2009 and 2015. The short-term outcomes included perioperative factors, while the long-term outcome included the recurrence rate. Of the 110 patients, 55 were female. The median age at surgery was 69.5years. Laparoscopic surgery was completed in 91.8%. The median operative time was 82min, median amount of bleeding was 0ml, and median postoperative hospital stay was 8days. Intraoperative major organ injury was seen in 2.7%. The complication rate (Clavien-Dindo≥class II) was 8.2%, and the mortality rate was 3.6%. The recurrence rate was 8.2%. Only dense and matted adhesion was a predictive factor for conversion (OR 30.244). Good short-term outcomes and feasible long-term outcomes were achieved with a laparoscopic approach to treating acute SBO. It was a safe and effective method, especially in patients with isolated bands, simple enteral angulation, and foreign body or tumor, while dense and matted adhesions were still challenging.