A prospective observational study of the utility of early diagnostic laparoscopy for right lower abdominal pain

a safe and effective diagnostic and therapeutic tool

Graeme J.K. Guthrie, Thomas Johnston, Anne Ewing, Russell Mullen, Stuart A. Suttie, Pradeep V. Patil

    Research output: Contribution to journalArticle

    Abstract

    Background and aims: Diagnostic laparoscopy is commonly performed for diagnosis of right lower abdominal pain and its use is increasing in the emergency setting. Some studies have reported that diagnostic laparoscopy and laparoscopic appendicectomy have advantages over conventional surgery. Many emergency surgeons now perform diagnostic laparoscopy for both clinically diagnosed appendicitis and when the diagnosis is in doubt. The aim of the present study was to assess whether the use of diagnostic laparoscopy is justified and safe for those admitted with right lower abdominal pain. Methods and results: Data were collected prospectively on consecutive patients attending the acute surgical receiving unit with right iliac fossa pain or a suspected diagnosis of acute appendicitis. A total of 284 patients underwent diagnostic laparoscopy. Of them 233 (82%) had a positive finding at laparoscopy, 207 (88%) underwent appendicectomy, the majority of which were carried out laparoscopically. Surgical trainees performed the majority of operations and this did not have a negative impact on operative findings (p 0.856), operation performed (0.642), or operative duration (0.831). No intra-operative complications were sustained. Ultrasound examination was carried out in 49 patients, while CT was carried out in 24. Conclusion: The results of the present study highlight the utility of early diagnostic laparoscopy as both a diagnostic and therapeutic tool in the acute setting.

    Original languageEnglish
    Pages (from-to)49-55
    Number of pages7
    JournalScottish Medical Journal
    Volume64
    Issue number2
    Early online date10 Jan 2019
    DOIs
    Publication statusPublished - 1 May 2019

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    Laparoscopy
    Abdominal Pain
    Observational Studies
    Prospective Studies
    Appendicitis
    Therapeutics
    Emergencies
    Pain

    Keywords

    • appendicitis
    • Diagnostic laparoscopy
    • right iliac fossa pain

    Cite this

    Guthrie, Graeme J.K. ; Johnston, Thomas ; Ewing, Anne ; Mullen, Russell ; Suttie, Stuart A. ; Patil, Pradeep V. / A prospective observational study of the utility of early diagnostic laparoscopy for right lower abdominal pain : a safe and effective diagnostic and therapeutic tool. In: Scottish Medical Journal. 2019 ; Vol. 64, No. 2. pp. 49-55.
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    A prospective observational study of the utility of early diagnostic laparoscopy for right lower abdominal pain : a safe and effective diagnostic and therapeutic tool. / Guthrie, Graeme J.K.; Johnston, Thomas; Ewing, Anne; Mullen, Russell; Suttie, Stuart A.; Patil, Pradeep V.

    In: Scottish Medical Journal, Vol. 64, No. 2, 01.05.2019, p. 49-55.

    Research output: Contribution to journalArticle

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