Orient Journal of Surgical Sciences

Background: Exploratory laparotomy is a surgical procedure performed in a patient who requires surgery when the actual cause and nature of the disease is not certain. Exploratory laparotomy is usually carried out as an emergency procedure in patients who are acutely ill and require urgent operation for control and stabilization of their disease condition.

Objective: The aim of this study is to evaluate the common indications for exploratory laparotomy among general surgery patients and to assess their post-operative outcome and complications. Methodology: This is a three-year retrospective study extending from January 2014 to December 2016. All the consecutive general surgery patients who had exploratory laparotomy within the study period were recruited into the survey. Patient's demographics including: age, sex, diagnosis, intra-operative findings, operative procedures, complications and outcomes were extracted and analysed. Analysis was done using the SPSS version 21.0.

Results: A total of 120 exploratory laparotomies were performed out of 1,908 surgical operations conducted within the study period (6.29% of total surgery). The age range was 4 - 85 years with a mean of 40.25±17.23 years and peaks in the 21-30 years and 31-40 years age groups. Seventy-six patients were males and 44 females giving a male to female ratio of 1.73:1. Intestinal obstruction from colonic tumours was the commonest indication constituting 28 (23.3%) followed by complicated appendicitis at 26 (21.6%). Bowel obstruction from post-operative bands, perforated peptic ulcer disease (PPUD) and abdominal trauma accounted for 25 (20.8%), 17 (14.2%) and 16 (13.3%) respectively. A total of 12 patients had complications following surgery representing a complication figure of 10.0%. Mortality rate was 4.2%.

Conclusion: Exploratory laparotomy is still very relevant in general surgery practice. Intestinal obstruction from colonic tumour was the commonest indication in the study. Post-operative complications and mortality rate were relatively low at 10.0% and 4.2% respectively.

Keywords: Laparotomy, Indications, Complications, Mortality.