Laparoscopic management of acute small bowel obstruction. Experience from a Saudi teaching hospital.

BACKGROUND The use of laparoscopy has expanded to include the management of acute abdomen. This study describes the author's experience with laparoscopic management of acute small bowel obstruction. METHODS From February 1994 through March 1998, 19 patients underwent laparoscopic intervention for acute small bowel obstruction. Their clinical data were analyzed to evaluate the outcome. RESULTS A total of 19 patients underwent 20 exploratory laparoscopies. The cause of obstruction was diagnosed correctly in 17 of the patients (90%). Fifteen patients (79%) had adhesions, nine of which were postoperative. Of the 19 patients, 13 (68%) had successful laparoscopic treatment. Laparotomy was required in six patients (32%) for various lesions including ileocecal tuberculosis. The average time for laparoscopy was 58 min. The mean postoperative hospital stay was 5 days. There was no morbidity or mortality in this series. CONCLUSIONS Laparoscopy is a feasible and safe alternative to laparotomy for most patients with acute small bowel obstruction.