Title: Laparoscopy in the treatment of peritonitis
- Bogdan Modzelewski, Adam Janiak
- Review articles
- Polish Gastroenterology
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- Final page:
- laparoscopy, peritonitis, pneumoperitoneum, inflammatory reaction, laparotomy conversion
The role of laparoscopy in the treatment of diffuse peritonitis (dp) is discussed in this article. From the clinical point of view, there is a need for laparoscopy in the initial stage of dp, before septic syndrome and multiorgan failure occur. Best results accompany the treatment of dp complicating acute appendicitis, chole-cystitis, or gastric and duodenal ulcer perforation. The duration of laparoscopic surgery is comparable to standard laparotomy, however complication rate of the former is smaller, as well as the mortality ratę. The conversion of laparoscopy to laparotomy is performed in 25% of patients. Worse results are observed in patients with complications of laparoscopic colon diseases. These patients manifest 85% conversion rate. Laparoscopy is a significant step forward in the treatment of dp, but all patients should be cautiously elected.