2016 Volume 36 Issue 1 Pages 37-43
We divided the patients who underwent emergency laparoscopic surgery for abdominal injury into penetrating trauma and blunt trauma groups, in order to retrospectively compare the rate of conversion from laparoscopic surgery to laparotomy, the reasons for the conversion to laparotomy, and any postoperative complications. We performed emergency laparoscopic surgery for 36 patients out of 112 patients who underwent surgery for abdominal injury in our hospital over the past 20 years. Among the injury types, blunt and penetrating traumas were observed in 17 and 19 patients, respectively. In 11 out of the 17 patients with blunt trauma, perforation of the digestive tract was confirmed, and mini-laparoscopic suture was performed for 5 patients. When 20 hours had passed from the injury in the patients with perforation, the frequency of conversion to laparotomy due to insufficient view caused by contamination was high. Among the 19 patients with penetrating trauma, only 2 exhibited perforation of the digestive tract. The incidences of unnecessary laparotomy and postoperative complications were 5.9% and 5.3% and 0% and 21%, respectively, in the blunt and penetrating trauma groups. No oversight of perforation of the digestive tract was confirmed. Regarding abdominal injury, laparoscopy is useful for the diagnosis of hollow organ injury, which is difficult to diagnose with CT, and the injury may be cured with a minimally invasive procedure under laparoscopic observation.
