Operative time was shortest in the laparoscopy group (74.3 ± 4.4 min), as was the duration of both intensive care unit and hospital stay. Mortality was 6%, regardless of operative technique. The author’s conclusion confirmed that the parameters associated with successful laparoscopic management of SBO are the presence of isolated bands, lower ASA scorse, younger age, fewer prior

operations, and a shorter duration of SBO obstruction before the operation. Reasons for primary laparotomy included a state of prolonged ileus with progressive abdominal distension and AZD5582 clinical trial a higher number or more extensive previous operations. Reasons for converting to open adhesiolysis following initial laparoscopy were inadequate laparoscopic control due to intestinal distension, extensive adhesions, iatrogenic intestinal perforation and the presence of necrotic segments of the small bowel upon initial laparoscopy, Selleck Nutlin3a requiring secondary open resection. Zerey et al. [131] reported a series of 33 patients underwent laparoscopic adhesiolysis secondary to a SBO. Twenty-nine patients (88%) were

successfully treated laparoscopically. Mean procedural time was 101 minutes (range, 19-198 minutes). Only one patient had a recurrent SBO 8 months postoperatively managed by repeat laparoscopic lysis of adhesions. Mean postoperative stay was 6 days. In another report of 65 patients submitted to laparoscopic adhesiolysis (40 for acute obstruction and 25 for chronic or recurrent transit disturbances) Thiamet G the procedure was completed by laparoscopy in 52 patients (conversion rate: 20%) and after a mean follow up of 48 months has been observed a 15.4% rate of symptomatic recurrences, while surgical Crenolanib concentration recurrences have been 4.6% [132]. In a series of 17 patients scheduled for elective adhesiolysis [133], laparoscopic treatment was successful in 14 patients (82.4%) and two

recurrences of small bowel obstructions were noted over a mean follow-up period of 61.7 months. In a similar series of elective laparoscopic treatment of 25 patients with recurrent small bowel obstruction, complete laparoscopic adhesiolysis was feasible in 18 patients (72%) and no recurrence of small bowel obstruction over a mean follow-up period of 41 months have been observed [134]. In this series conversion to laparoscopic-assisted adhesiolysis (mini-laparotomy with an incision less than 4 cm long) was required in 6 patients (24%) because of dense adhesion or the technical difficulties due to adhesion in the pelvic cavity. Leon et al.