Emergency Laparotomy

Geeta Aggarwal; Michael Scott; Carol J Peden

doi:10.1016/j.anclin.2021.11.010

Emergency Laparotomy

Anesthesiol Clin. 2022 Mar;40(1):199-211. doi: 10.1016/j.anclin.2021.11.010.

Authors

Geeta Aggarwal¹, Michael Scott², Carol J Peden³

Affiliations

¹ Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK. Electronic address: geetaaggarwal@nhs.net.
² Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Surgical Outcomes Research Centre, University College London, London, UK.
³ Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Clinical Quality the Blue Cross Blue Shield Association, Chicago, IL 60601, USA.

PMID: 35236580
DOI: 10.1016/j.anclin.2021.11.010

Abstract

Emergency laparotomy is a high-risk surgical procedure with mortality and morbidity up to 10 times higher than for a similar procedure performed electively. An enhanced recovery approach has been shown to improve outcomes. A focus on rapid correction of underlying deranged acute physiology and proactive management of conditions associated with aging such as frailty and delirium are key. Patients are at high risk of complications and prevention and avoidance of failure to rescue are essential to improve outcomes. Other enhanced recovery components such as opioid-sparing analgesia and early postoperative mobilization are beneficial.

Keywords: Emergency general surgery; Emergency laparotomy; Enhanced recovery; Geriatric management; Surgical outcomes.

Publication types

Review

MeSH terms

Frailty* / complications
Humans
Laparotomy* / adverse effects
Postoperative Complications / etiology
Postoperative Complications / prevention & control
Postoperative Period