BACKGROUND: Most blunt @entity99 @entity1 can be managed nonoperatively. The current failure rate in adult blunt @entity99 is reportedly 0 to 19%. We wished to evaluate the applicability of laparoscopy and fibrin glue as a minimally invasive alternative to laparotomy in these unsuccessfully nonoperative cases. METHODS: All adult @entity1 with blunt @entity99 managed nonoperatively at Linkou, Chang Gung Memorial Hospital Medical Center, Taipei, Taiwan, over a 2-year period from July 1, 1994, to June 30, 1996, were eligible for the study. A laparoscopic examination was performed on those who failed conservative care before undertaking an exploratory laparotomy. Fibrin glue was sprayed over the wound surface if ongoing @entity548 was evident from any @entity409 . The clinical data, operative and laparoscopic findings, operative methods, and outcomes of these @entity1 were studied. RESULTS: Of the 61 @entity1 , 55 @entity1 were successfully treated without operation. Of the six failures (10%) all were liver related. After the introduction of laparoscopy, the nontherapeutic laparotomy rate would have decreased from 100% (6 of 6) to 50% (3 of 6), and with the adjunctive use of fibrin glue, the laparotomy rate went down to 0% (0 of 6). There were no deaths among the six @entity1 receiving laparoscopy and fibrin glues; and only one developed a @entity5572 , for a morbidity rate of 17% (1 of 6). CONCLUSIONS: The selective use of laparoscopy and fibrin glue can effectively reduce the nontherapeutic laparotomy rate among blunt @entity99 @entity1 who fail nonoperative management.

Selective application of laparoscopy and fibrin glue in the failure of nonoperative management of blunt XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5572 :: ('MESH:D008100', 'Disease') :: ['liver abscess'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage'] @entity409 :: ('MESH:D008107', 'Disease') :: ['liver laceration'] @entity99 :: ('MESH:D056486', 'Disease') :: ['hepatic trauma']
@entity99 :: (MESH:D056486,Disease) :: ['hepatic trauma']
