The Significance of Emergency Laparoscopic Surgery for Acute Abdomen, Especially Generalized Peritonitis

Sixty-one patients who underwent emergency laparoscopic surgery with the diagnosis of generalized peritonitis at the hospital from August 1992 to August 1996 were subjected to a study of the usefulness and problems of the procedure. Items investigated included pre- and postoperative diagnosis, postoperative complication, and cases required open laparotomy. As a result, the most frequent diagnosis was acute appendicitis followed by gynecological diseases. Almost all patients with gynecological diseases were safely treated by laparoscopic procedure without unnecessary open laparotomy of these 61 patients, 15 patients （24.6%） underwent laparoscopic surgery with no definitive diagnosis, but laparoscopic examination revealed some underlying disease in 12 0ut of 15 cases. another 15 patients （24.6%） were performed open laparotomy following laparoscopic examination. Postoperative complications included paralytic ileus, strangulation ileus, pneumonia, liver dysfunction, fat lysis of the wound where a laparoscope was inserted, but there were no wound infection nor intraperitoneal abscess. We considered that laparoscopic surgery is not only a useful diagnostic technique but also an effective therapeutic method for acute abdomen