eP290 Laparoscopic Emergency Surgery In A District General Hospital - A Five Year Experience

Aims To evaluate the use of laparoscopy in the management of acute surgical emergencies presenting to a district general hospital Methods Retrospective analysis of data collected from hospital records of all patients who presented to the unselected acute general surgical intake over a five year period. Patients who presented with emergency bowel obstruction (large and small bowel obstruction), hollow viscus perforation, trauma and bowel ischaemia were included in the study. Results Data was collected from 30 patients who underwent emergency general surgery for acute surgical emergencies. All procedures were performed under general anaesthesia. Average age was 67 years (36-91). Male: Female ratio was 9:21. ASA Grade varied between I to IV. The average operating time was 82 minutes (32-209). Majority {17(57%) } of the procedures were performed to treat adhesive small bowel obstruction. Other indications include gallstone ileus, internal bowel herniation, traumatic bowel injuries, obstructed parastomal hernia and duodenal ulcer perforation. In these five categories a total of 10 (33%) patients underwent laparoscopic procedures. One procedure each was performed on 3(10%) patients who presented with volvulus of the bowel, bowel ischaemia and leak following sleeve gastrectomy. 21(70%) of procedures were completed laparoscopically with 9(30%) needing open conversion. There were no immediate postoperative deaths within the 30 day period. Conclusions Laparoscopic surgery can be used in the emergency setting in a district general surgical hospital with safe outcomes. A variety of acute surgical conditions can be managed with the minimally invasive approach reducing the need for a laparotomy.