[Perforated peptic ulcer and laparoscopic treatment].

Background: The purpose of this study is to evaluate the possibility, safety and advantages of laparoscopic approach in the diagnosis and therapy of perforated peptic ulcer.

Methods: This is a retrospective study including 69 cases of gastroduodenal perforation initially treated laparoscopically. The safety (morbidity and mortality) was estimated according to the two mortality rates fixed for laparotomies, APACHE II and Mannheimer Peritonitis Index (MPI).

Laparoscopic management of acute peritonitis.

Background: The presence of peritonitis has previously been considered to be a contraindication for the laparoscopic approach because of the theoretical risk of malignant hypercapnia and toxic shock syndrome. The aim of this retrospective study was to demonstrate that laparoscopy is feasible, safe and efficient in cases of peritonitis.

Methods: From January 1990 to July 1995, 231 patients had a laparoscopy for acute peritonitis in two centres (91 appendicular peritonitis, 69 gastroduodenal perforated ulcers, 35 perforations of the colon, 36 miscellaneous).

[Is laparoscopic cholecystectomy effective and reliable in acute cholecystitis? Results of a prospective study of 221 pathologically documented cases].

From December 1989 to May 1995, a prospective study of laparoscopic cholecystectomy was carried out in our department, in order to assess the reliability and safety of this method in the case of acute cholecystitis. During this period, 1453 patients underwent laparoscopic cholecystectomy. Acute cholecystitis was diagnosed in 280 patients, based on clinical history and macroscopic lesions.

Postoperative acalculous cholecystitis. A five-case study and a literature review.

The study reports five cases of postoperative acute acalculous cholecystitis. Clinical symptoms are upper abdominal pain, fever, jaundice or an unexplained septic shock. Biology orients the diagnosis but only gallbladder ultrasonography and, to a lesser degree, hepatobiliary scintigraphy are really diagnostic.