The Role of Laparoscopy in Upper Abdominal Surgical Emergencies in Adults: A Retrospective Observational Study.

Introduction Laparoscopy can be used to diagnose and treat the etiologies of acute abdominal pain. This study aimed to assess laparoscopy's effectiveness in upper gastrointestinal (G.I.T) emergencies regarding intra-and postoperative outcomes.

Method: A retrospective observational study was conducted in the emergency departments of Zagazig University on 215 patients who had upper abdominal emergency surgeries between June 2017 and June 2020.

Study Overview

• Status: Completed
• Conditions: Acute Abdomen
• Intervention / Treatment: Procedure: laparoscopy in upper abdominal surgical emergencies in adults

Detailed Description

When surgical procedures are standardized, laparoscopy's benefits in a range of emergency scenarios are without question acknowledged. When only a basic strategy is set for the surgery, and the surgical approach entirely depends on intra-abdominal findings, the benefits are diminished or unknown. The evidence unequivocally supports the superiority of a laparoscopic approach in numerous emergency cases, such as acute cholecystitis, gastroduodenal perforated ulcers, infected pancreatic necrosis, and splenic injuries Laparoscopy gives the primary advantages of a shorter hospital stay, a quicker procedure, and faster recovery without complications. Rapid recovery is connected with early enteral feeding. Adequate nutritional support aids in maintaining homeostasis and, as a result, enhances immunity, thereby decreasing the incidence of wound infection. Laparoscopy should be considered with caution whenever abdominal access is considered difficult, as in cases of organ enlargement, adhesion, and bowel distension. In actuality, creating the pneumoperitoneum is an essential step in the procedure. Increased intraperitoneal pressure produces cardio-respiratory and neurological effects.

In this study, the investigators designed a retrospective observational study to present our experience in assessing the outcomes of a laparoscopic approach in emergent upper abdominal surgery in terms of intraoperative and postoperative complications.

• Study Type: Observational
• Enrollment (Actual): 215

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Between June 2017 and June 2020, 215 patients were admitted to Zagazig University Hospital's emergency surgical unit with clinical diagnoses of upper G.I.T. emergencies, namely acute cholecystitis, perforated P.U., acute necrotizing pancreatitis, and splenic trauma. The work has been reported following STROBE guidelines. To be included in the study, patients must meet the following criteria: >18 years of both sexes complaining of acute upper G.I.T. emergencies and undergoing laparoscopic surgeries, namely acute cholecystitis, perforated peptic ulcer, pancreatic necrosis, and splenic injuries. < 18 years of age and open surgeries for upper G.I.T. emergency surgeries were excluded.

Description

Inclusion Criteria:

• clinical diagnoses of upper G.I.T. emergencies, namely acute cholecystitis, perforated P.U., acute necrotizing pancreatitis, and splenic trauma.

Exclusion Criteria:

• < 18 years of age and
• open surgeries for upper G.I.T.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
intraoperative complications requiring conversion	the number of patients converted to open approach	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
postoperative complications requiring reintervention	reintervention	within 2 years of surgery

Collaborators and Investigators

• Sponsor: Zagazig University

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2017
• Primary Completion (ACTUAL): June 1, 2020
• Study Completion (ACTUAL): June 1, 2022

Study Registration Dates

• First Submitted: October 7, 2022
• First Submitted That Met QC Criteria: October 21, 2022
• First Posted (ACTUAL): October 24, 2022

Study Record Updates

• Last Update Posted (ACTUAL): October 24, 2022
• Last Update Submitted That Met QC Criteria: October 21, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Emergency surgery; Laparoscopy; Upper abdominal surgery
• Additional Relevant MeSH Terms: Pathologic Processes; Pain; Neurologic Manifestations; Disease Attributes; Signs and Symptoms, Digestive; Abdominal Pain; Emergencies; Abdomen, Acute
• Other Study ID Numbers: zagazig university 12

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No