caa a22 4500 475780213 CHVBK 20180406123642.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1007/s004640000197 doi (NATIONALLICENCE)springer-10.1007/s004640000197 Majewski W. Department of General Surgery and Transplantation, Pomeranian Medical University, 72, Powstańców Wlkp. St., PL 70-111, Szczecin, Poland aut Diagnostic laparoscopy for the acute abdomen and trauma [Elektronische Daten] [W. Majewski] Background: We set out to investigate the potential benefits of routine diagnostic laparoscopy (DL) in cases of acute abdomen. Methods: A prospective study of 120 DL in acute abdominal cases was performed in comparison with 310 similar acute abdominal cases treated without DL. The diagnostic accuracy, hospital stay, therapeutic delay, and convalescence time were then evaluated. Results: DL established the indications for intervention in 96% of cases, yielded a diagnosis in 90%, and changed the treatment in 14%. The sensitivity achieved was 99.3%, specificity was 83.3%, and accuracy was 88.6%. There were two false positives, one false negative, and three results insufficient to make a diagnosis. Morbidity was one (0.8%), and mortality was one (0.8%). Seventy-nine patients (66%) were managed by laparoscopy and 24 by open interventions. The hospital stay in DL groups was shorter (median, 5 days vs 6 days in controls, p<0.0003), as was the effective treatment time (median, 5 days vs 6 days, p<0.0012). The convalescence time was also shorter in DL groups (median, 14 days vs 14 days, p<0.04). Therapeutic delay occurred in 16% of the control group cases, doubling the morbidity rate, increasing mortality by 50%, and prolonging hospital stay (median, 9 days vs 6 days, p>0.3 (NS). Conclusions: DL in the acute abdomen is a safe and accurate procedure that enables laparoscopic interventions and helps avoid nontherapeutic surgery. DL and appropriate treatment reduces hospital stay, therapeutic delay, and convalescence time. Springer-Verlag, 2000 Diagnostic laparoscopy nationallicence Acute abdomen nationallicence Abdominal trauma nationallicence Surgical Endoscopy Springer-Verlag 14/10(2000-10-01), 930-937 0930-2794 14:10<930 2000 14 464 https://doi.org/10.1007/s004640000197 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000197 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Majewski W. Department of General Surgery and Transplantation, Pomeranian Medical University, 72, Powstańców Wlkp. St., PL 70-111, Szczecin, Poland aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/10(2000-10-01), 930-937 0930-2794 14:10<930 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer