Abstract
Background. Postoperative abdominal adhesions may cause small bowel
obstruction (SBO), chronic abdominal pain or both. Traditionally open
adhesiolysis in some situations may be necessary for treatment of these
cases. Laparoscopy has a role in both diagnosis and treatment of such
complications. This study tried to evaluate the role of laparoscopic
adhesiolysis in management of these complications.
Patients and Methods. This was a prospective study which randomly
included 23 patients who had laparoscopic adhesiolysis for diagnosis and
treatment of patients suffering of partial recurrent SBO or chronic abdominal
pain secondary to postoperative adhesions which were expected to be mostly
a single adhesion after failure of conservative management from June 2008
to September 2010, at Sohag University Hospital.
Results. Laparoscopic adhesiolysis was performed on 15 patients with
recurrent incomplete SBO and on 8 patients with chronic abdominal pain.
Eighteen patients’ operations (78.3%) were completed laparoscopically.
Three operations (13%) were converted to open adhesiolysis due to marked
adhesions; 2 cases of them were operated for recurrent partial SBO, and 1
patient was suffering of chronic abdominal pain in addition. Two patients
with negative findings were referred for psychological counseling and
excluded from the study follow up. Eleven patients (61%) reported
recurrence of their symptoms by one year and open re-adhesiolysis was
necessary for management of 3 patients (17%). The follow-up period ranged
from 2 to 12 (mean 8) months.
Conclusion. Laparoscopic adhesiolysis has a role in diagnosis and treatment
of postoperative adhesions, but it is not a better alternative for open
adhesiolysis.