Laparoscopic approach was initially attempted in 10 patients; however, 2 www.selleckchem.com/products/Temsirolimus.html cases required conversion to open technique due to severe peritonitis. The average LOS for the laparoscopic group was 7.1 days. This rather prolonged LOS was in part due to the discouragement of early discharge in the institutions in which the procedures were performed. Despite this, the authors reported significantly shorter LOS for the laparoscopic approach in comparison to the open technique (7.1versus14.3 days, P = 0.019). In the same year, Bleier et al. [6] published a study comparing outcomes following open and laparoscopic primary repair for the management of iatrogenic colonic perforations. Patient demographics were similar between both groups. The LOS was significantly shorter for the laparoscopic group (5versus9 days, P = 0.

01). Furthermore, the complication rate was lower in the laparoscopic group (2/12versus5/7, resp., P = 0.01). In this comparative study, the authors concluded that the laparoscopic primary repair, when performed by experienced laparoscopic surgeons, is advantageous over the open technique. The present study evaluated the outcomes of our initial experience utilizing laparoscopic primary repair for the treatment of acute iatrogenic colonic perforations during colonoscopy. We found this minimally invasive approach to be safe and feasible for such cases. Accordingly, we currently consider this modality as an initial approach for the management of such perforations. If favorable conditions exist (e.g., minimal spillage, absence of sepsis), we could primarily repair.

Otherwise, laparoscopic resection with ostomy creation should be entertained. None of our cases required conversion to open surgery; however, if the minimally invasive platform proves unsuccessful, a conversion to laparotomy can be readily performed. 5. Conclusion Laparoscopic primary colorrhaphy is a safe and feasible approach for the management of acute colonoscopic perforations. Conventional laparoscopic suture repair facilitates a minimally invasive procedure with minimal surgical trauma, rapid postoperative recovery, and low complication rate. Early comparative studies have demonstrated comparable efficacy with open techniques for repair of perforations. Consequently, laparoscopic primary colon repair may increasingly play an important role as a therapeutic option in the future management of various perforations.

Additional prospective comparative studies will be necessary to further elicit the benefits and limitations of this approach. Conflict of Interests Dr. Haas, Dr. Pedraza, Dr. Ragupathi, Dr. Mahmood, and Dr. Pickron have no conflict of interests or financial ties to disclose.
Ten percent (2�C15%) Carfilzomib of all acute cholecystitis is not associated with cholelithiasis [1].