Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2015; 7(8): 160-169
Published online Aug 27, 2015. doi: 10.4240/wjgs.v7.i8.160
Laparoscopic management of intra-abdominal infections: Systematic review of the literature
Federico Coccolini, Cristian Tranà, Massimo Sartelli, Fausto Catena, Salomone Di Saverio, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni
Federico Coccolini, Roberto Manfredi, Giulia Montori, Marco Ceresoli, Chiara Falcone, Luca Ansaloni, General Surgery Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
Cristian Tranà, Massimo Sartelli, General and Emergency Surgery Department, Macerata Hospital, 62010 Macerata, Italy
Fausto Catena, General and Emergency Surgery Department, Maggiore Hospital, 43100 Parma, Italy
Salomone Di Saverio, General and Trauma Surgery Department, Maggiore Hospital, 62039 Bologna, Italy
Author contributions: Coccolini F, Tranà C, Ansaloni L designed research; Coccolini F, Sartelli M, Tranà C, Catena F, Manfredi R and Ceresoli M analyzed data; Coccolini F, Tranà C, Sartelli M, Montori G and Ceresoli M wrote the paper; all authors read and approved the manuscript.
Conflict-of-interest statement: All authors declare to have no conflict of interest to declare.
Data sharing statement: Statistical code, and dataset are available from the corresponding author at No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Federico Coccolini, MD, General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
Telephone: +39-35-2673486 Fax: +39-35-2674963
Received: February 3, 2015
Peer-review started: February 6, 2015
First decision: April 13, 2015
Revised: April 15, 2015
Accepted: July 7, 2015
Article in press: July 8, 2015
Published online: August 27, 2015

AIM: To investigate the role of laparoscopy in diagnosis and treatment of intra abdominal infections.

METHODS: A systematic review of the literature was performed including studies where intra abdominal infections were treated laparoscopically.

RESULTS: Early laparoscopic approaches have become the standard surgical technique for treating acute cholecystitis. The laparoscopic appendectomy has been demonstrated to be superior to open surgery in acute appendicitis. In the event of diverticulitis, laparoscopic resections have proven to be safe and effective procedures for experienced laparoscopic surgeons and may be performed without adversely affecting morbidity and mortality rates. However laparoscopic resection has not been accepted by the medical community as the primary treatment of choice. In high-risk patients, laparoscopic approach may be used for exploration or peritoneal lavage and drainage. The successful laparoscopic repair of perforated peptic ulcers for experienced surgeons, is demonstrated to be safe and effective. Regarding small bowel perforations, comparative studies contrasting open and laparoscopic surgeries have not yet been conducted. Successful laparoscopic resections addressing iatrogenic colonic perforation have been reported despite a lack of literature-based evidence supporting such procedures. In post-operative infections, laparoscopic approaches may be useful in preventing diagnostic delay and controlling the source.

CONCLUSION: Laparoscopy has a good diagnostic accuracy and enables to better identify the causative pathology; laparoscopy may be recommended for the treatment of many intra-abdominal infections.

Keywords: Laparoscopy, Post-operative, Treatment, Perforation, Appendicitis, Cholecystitis, Diverticulitis, Infection, Pregnancy

Core tip: Laparoscopic procedures have become widely accepted as a primary means of diagnosing and treating intra-abdominal infections (IAIs). The diagnostic accuracy of laparoscopy enables surgeons to better identify the causative pathology of acute abdominal pain, and related procedures can be employed to effectively treat a variety of IAIs. Depending on the patient’s symptoms, pathological severity, and the attending surgeon’s personal experience, laparoscopy may be recommended for the treatment of many IAIs.