Diagnostic And Therapeutic Laparoscopy in Acute And Subacute Abdominal Conditions: A Prospective Observational Study From A Tertiary Care Centre in North India

Abstract

Background: Diagnostic laparoscopy provides direct visualization of the peritoneal cavity and can combine diagnostic clarification with definitive minimally invasive treatment. Its role is particularly relevant when clinical assessment and imaging are inconclusive or when unexpected pathology is encountered.

Methods: This prospective observational study included 47 consecutive haemodynamically stable adults undergoing diagnostic laparoscopy for acute or subacute abdominal conditions at Subharti Medical College between November 2024 and March 2026. Demographic characteristics, indications, intraoperative findings, therapeutic procedures, conversion to open surgery, and postoperative outcomes were prospectively recorded.

Results: The mean age was 39.8 ± 3.9 years; 28 patients (59.6%) were female and 19 (40.4%) were male. Biliary pathology was the predominant indication (31/47, 65.9%), followed by appendicitis (8/47, 17.0%) and abdominal wall hernias (5/47, 10.6%). Laparoscopy identified clinically relevant unexpected findings, including biliary and vascular anatomical variations, portal cavernoma, empyema, occult gallbladder carcinoma, abdominal tuberculosis, inflammatory adhesions, bowel injury, and sealed appendicular perforation. Most patients underwent definitive laparoscopic treatment; three (6.4%) required conversion to open surgery.

Conclusion: In appropriately selected haemodynamically stable patients, diagnostic laparoscopy is a useful diagnostic and therapeutic strategy for acute and subacute abdominal conditions. It permits direct assessment, facilitates same-setting treatment, and supports timely conversion when anatomy or disease severity makes minimally invasive completion unsafe.