DIAGNOSTIC LAPAROSCOPY IN THE INTENSIVE-CARE PATIENT - AVOIDING THE NONTHERAPEUTIC LAPAROTOMY

被引：44

作者：

BRANDT, CP

PRIEBE, PP

ECKHAUSER, ML

机构：

[1] Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, 44109-1998, OH

来源：

SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES | 1993年 / 7卷 / 03期

关键词：

ACUTE ABDOMEN; ICU; DIAGNOSTIC LAPAROSCOPY;

D O I：

10.1007/BF00594100

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Evaluation of a potential acute abdomen in patients who require intensive care for concurrent medical/surgical problems is often difficult due to ambiguities in the physical exam and ancillary diagnostic tests. Between August 1990, and February 1992, 25 ICU patients underwent diagnostic laparoscopy to evaluate a suspected acute intraabdominal process. Thirteen laparoscopies were negative, and 12 were positive. The overall accuracy for laparoscopy was 96% as confirmed by subsequent laparotomy, autopsy, or clinical course. Laparoscopic findings led to a change in management in nine patients (36%), leading to earlier exploration in four patients, and avoidance of laparotomy in five. No significant hemodynamic effects were noted during laparoscopy, and the procedure-related morbidity was low (8.0%). Diagnostic laparoscopy is a safe and accurate guide for managing the ICU patient with a suspected acute surgical abdomen. The use of laparoscopy can help avoid nontherapeutic laparotomy or confirm the need for operative intervention in these complex cases.

引用

页码：168 / 172

页数：5

共 21 条

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