Background: Emergency Surgery is growing nowadays as separate subspeciality from general surgery in many
countries. Minimally invasive approach is currently utilized routinely in most of the elective abdominal surgeries
due to its better outcomes to the open approach but is not widely used as the same in setting of major abdominal
emergencies. We aimed in our study to evaluate the role of laparoscopy in management of major abdominal
emergencies in our busy tertiary university hospital.
Patients and methods: A retrospective cohort analysis of total 1740 eligible patients' records who underwent
emergency major abdominal surgery for abdominal trauma, generalised peritonitis, and bowel obstruction. Cohort
were divided into three groups; those who underwent emergency laparotomy (OP), completed laparoscopic
surgery (LA) and laparoscopy converted to open (LAC). Demographic data, operations type, causes of conversion,
perioperative outcomes, and hospital stay of the groups were compared and statistically analysed.
Results: Total number of 1322 (79%) patients in (OP) group, and 418 (31%) had attempted diagnostic laparoscopy
and proceed (DLP), with 157 out of total 418 (37.5%) patients were converted to open (LAC) mainly for inadequate
exposure (36.3%). Laparoscopic surgery was completed in only 15% of the total patients in our study (261/1740)
and was mainly for management of peritonitis (90%). LA group had significantly lower rate of surgical site infection
(SSI), respiratory complications, shorter ileus time, hospital and ICU stay, with lower hospital mortalities.
Conclusion: Utilization of laparoscopy is still less favourable in emergency surgery, but it is feasible and effective
approach by experienced surgeons in selected patients with significant quicker recovery, shorter hospital stay and
lower rate of surgical site and respiratory complications.