Document Detail

Laparoscopy in the critically ill.
MedLine Citation:
PMID:  9348376     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Laparoscopy was evaluated in critically ill patients with suspected acute cholecystitis, mesenteric ischemia, or gastrointestinal perforation. We studied laparoscopy to assess its utility, accuracy, and effect on cardiopulmonary stability. METHODS: Twenty-six surgical ICU patients with possible abdominal sepsis underwent laparoscopy. Nineteen were post cardiac surgery; the remainder had other diagnoses. Video laparoscopy was performed with hemodynamic monitoring and inotropic support as needed. Eight patients had bedside laparoscopy. RESULTS: Fifteen patients had suspected acute cholecystitis. Laparoscopy was positive in 10; four had open cholecystectomy, four laparoscopic cholecystectomy, and two tube cholecystostomy. Nine patients had suspected mesenteric ischemia; laparoscopy was positive in five, revealing cirrhosis in two and ischemic bowel in three. Two patients had suspected perforated viscus with colonic perforation in one and one false negative. There were no adverse hemodynamic events. CONCLUSIONS: Laparoscopy can be performed safely in critically ill patients. It is useful in patients with acute cholecystitis and in patients who are post cardiac surgery with refractory lactic acidosis in whom a diagnosis of mesenteric ischemia is considered.
R Orlando; K L Crowell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  11     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-01-20     Completed Date:  1998-01-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  1072-4     Citation Subset:  IM    
Department of Surgery, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102-5037, USA, and University of Connecticut School of Medicine, Farmington, CT 06034, USA.
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MeSH Terms
Acute Disease
Aged, 80 and over
Cholecystitis / diagnosis*
Critical Illness*
Ischemia / diagnosis*
Mesentery / blood supply*
Middle Aged
Retrospective Studies
Surgical Instruments

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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