Laparoscopy

The final role of laparoscopic surgery for the management of inflammatory bowel disease is still under evaluation, but it is attractive. Since it is well known that development of laparoscopic techniques is not reserved for university centres or high volume hospitals, minimal invasive procedures can also be applied in peripheral hospitals. Certainly, laparoscopy is not the first choice approach in the emergency treatment of our patients with inflammatory bowel disease, but we do not hesitate to perform a diagnostic laparoscopy in patients with known inflammatory bowel disease which present with unclear acute abdominal complaints. In this way, we managed a cecal perforation in a patient with Crohn's disease and cecal carcinoma by direct closure of the perforation and peritoneal lavage and drainage. Laparoscopic ileocolic resection is a feasible procedure for skilled surgeons. When compared with an open approach, laparoscopic ileocolic resection led to lower 5-year small-bowel obstruction rates in selected patients with ileocecal Crohn's disease, whereas the 5-year recurrence rates did not differ [63].

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