[Celioscopic treatment of acute obstructions caused by adhesions of the small intestine. Experience of 35 cases].

Postoperative adhesions are the primary cause of occlusion of the small bowel. We evaluated the feasibility and the immediate postoperative results of laparoscopic procedures for acute adhesions on the small bowel. Between September 1992 and March 1995, we performed laparoscopic procedures in 35 patients with acute occlusion of the small bowel. The preoperative work-up highly suggestive of adhesion. There were 17 males and 18 females, mean age 48.2 years. In 30 patients, the operation confirmed the preoperative diagnosis of occlusion by adhesions. Lysis was performed entirely via the laparoscopic route in 21 of the 30 patients (70%). Immediate postoperative complications were 3 bowel lesions. Intestinal mobility was re-established in 1.8 days after operation and the mean duration of hospitalization was 5 days for patients with laparoscopic procedure alone compared with 3.4 days for intestinal mobility and 10.4 days hospitalization for the 9 patients who were converted to laparotomy. An eventration of the trocar orifice occurred late in one patient and ischaemic stenosis of the bowel required laparotomy in another. There were no deaths. Laparoscopic treatment of adhesion occlusions is a feasible operation. Morbidity is low in experienced hands. The immediate benefit is rapid intestinal mobility and shorter hospital stay. The effect on long-term risk to be evaluated.