Navez B, d'Udekem Y, Cambier E, Richir C, Guiot P
Service de Chirurgie Générale Digestive et Urologique, Hôpital Saint-Joseph, Gilly (Charleroi), Belgique.
Ann Chir. 1994;48(7):625-31.
The diagnostic and therapeutic value of laparoscopy in emergency was studied in 314 patients presenting with non-traumatic acute abdomen. Laparoscopy gave a correct and complete diagnosis of the underlying disease in 92% (290/314) of cases. An erroneous preoperative diagnosis was corrected by laparoscopy in 18% (58/314) of cases. This implied a change of the therapeutic strategy in 9% (27/314). Seventy five per cent (234/314) of patients were exclusively treated by laparoscopy, 22% (68/314) by laparotomy and 3% (11/314) by laparoscopically assisted surgery. Mortality was 2.5% (8/314) and morbidity 9% (29/314). In conclusion, laparoscopy is a valuable diagnostic tool for the surgeon in the context of acute abdomen and is an interesting therapeutic alternative in selected cases. However, it requires extensive experience in laparoscopic techniques.
对314例非创伤性急腹症患者研究了腹腔镜检查在急诊中的诊断和治疗价值。腹腔镜检查对92%(290/314)的病例做出了正确且完整的潜在疾病诊断。在18%(58/314)的病例中,腹腔镜检查纠正了术前错误诊断。这意味着9%(27/314)的治疗策略发生了改变。75%(234/314)的患者仅接受腹腔镜检查治疗,22%(68/314)接受剖腹手术治疗,3%(11/314)接受腹腔镜辅助手术治疗。死亡率为2.5%(8/314),发病率为9%(29/314)。总之,腹腔镜检查对急腹症外科医生而言是一种有价值的诊断工具,并且在某些特定病例中是一种有趣的治疗选择。然而,它需要丰富的腹腔镜技术经验。