LAPAROSCOPY FOR THE EVALUATION OF ANTERIOR ABDOMINAL STAB WOUNDS IN HEMODYNAMICALLY STABLE PATIENTS

Aim: To evaluate the role of laparoscopy in the management of anterior abdominal stab injuries in hemodynamically stable patients. Methods: This prospective study was done at The Department of Surgery, Minia University Hospital, between July 2006 and December 2007. It included 29 patients (24 males and 5 females). Patients were divided according to the laparoscopic findings to four groups: negative, positive nontherapeutic, positive therapeutic and laparotomy groups. Results: Laparoscopy was positive in 27 of 29 patients (93.1%) and negative in two patients (6.9%). It was positive non therapeutic in 14 patients (48.2%), positive therapeutic in 3 patients (10.3%), and needed conversion to laparotomy in 10 patients (34.4%). Therapeutic laparoscopy was done in 3 patients (10.3%) and included: gastric repair in one patient, diaphragmatic repair in one patient, and bleeding control of liver injury in one patient. Laparoscopy was converted to laparotomy in 10 patients (34.4%). Laparotomy was avoided in a total of 19 (65.5 %) patients. There was no mortality and minimal morbidity. The mean follow up was 9±2 months. Conclusion: Laparoscopy is safe and efficient in the management of the anterior abdominal stab injuries in hemo dynamically stable patients. It is associated with minimal morbidity and no mortality. Laparotomy is still indicated in extensive injuries