{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:35:44Z","timestamp":1784068544504,"version":"3.55.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2009,2,25]],"date-time":"2009-02-25T00:00:00Z","timestamp":1235520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2009,2,25]],"date-time":"2009-02-25T00:00:00Z","timestamp":1235520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Delayed diagnosis of intraabdominal pathology in the intensive care unit (ICU) increases rates of morbidity and mortality. Intraabdominal pathologies are usually identified through presenting symptoms, clinical signs, and laboratory and radiological results; however, these could also delay diagnosis because of inconclusive laboratory tests or imaging results, or the inability to safely transfer a patient to the radiology room. In the current study we evaluated the safety and accuracy of bedside diagnostic laparoscopy to confirm the presence of intraabdominal pathology in an ICU setting.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>This retrospective study, carried out between January 2006 and June 2008, evaluated the diagnostic accuracy of bedside diagnostic laparoscopy performed on patients with a suspicion of ongoing intraabdominal pathology. Clinical indications for bedside diagnostic laparoscopy were: ultrasonography (US) images of gallbladder distension or wall thickening of more than 3 to 4 mm, with or without pericholecystic fluid; elevation of laboratory tests (bilirubin, transaminases, myoglobin, lactate dehydrogenase, creatine phosphokinase, gamma-glutamyltransferase); high level of lactate\/metabolic acidosis; CT images inconclusive for intraabdominal pathology; or inability to perform a CT scan. Patients did not undergo bedside diagnostic laparoscopy if they presented clear indications for open surgery, coagulopathy, abdominal wall infection or high intraabdominal pressure.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Thirty-two patients underwent bedside diagnostic laparoscopy (Visiport Plus, Autosuture, US), 14 of whom had been admitted to the ICU for major trauma, 12 for sepsis of unknown origin and 6 for complications after cardiac surgery. The procedure was performed on an average of eight days after ICU admission (95% confidence interval = 5 to 15 days) and mean procedure duration was 40 minutes. None of the procedures resulted in complications. Bedside diagnostic laparoscopy was diagnostic for intraabdominal pathology in 15 patients, who subsequently underwent surgery, except in two cases of diffuse gut hypoperfusion. Diagnosis of cholecystitis was obtained in seven cases: two were treated with laparotomic cholecystectomy and five with percutaneous gallbladder drainage positioning.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Bedside diagnostic laparoscopy represents a safe and accurate technique for diagnosing intraabdominal pathology in an ICU setting and should be taken into consideration when patient transfer to radiology or the operating room is considered unsafe, or when routine radiological examinations are not conclusive enough to reach a definite diagnosis.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc7730","type":"journal-article","created":{"date-parts":[[2009,3,5]],"date-time":"2009-03-05T19:41:46Z","timestamp":1236282106000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Bedside diagnostic laparoscopy to diagnose intraabdominal pathology in the intensive care unit"],"prefix":"10.1186","volume":"13","author":[{"given":"Adriano","family":"Peris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Matano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Manca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Zagli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Bonizzoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pasquini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Batacchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Di Filippo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Anichini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Nicoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Benemei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierangelo","family":"Geppetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2009,2,25]]},"reference":[{"key":"7163_CR1","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/0002-9610(83)90042-9","volume":"145","author":"R Orlando 3rd","year":"1983","unstructured":"Orlando R 3rd, Gleason E, Drezner AD: Acute acalculous cholecystitis in the critically ill patient.\n                           Am J Surg 1983, 145: 472-476. 10.1016\/0002-9610(83)90042-9","journal-title":"Am J Surg"},{"key":"7163_CR2","first-page":"471","volume":"64","author":"S Kalliafas","year":"1998","unstructured":"Kalliafas S, Ziegler DW, Flancbaum L, Choban PS: Acute acalculous cholecystitis: incidence, risk factors, diagnosis, and outcome.\n                           Am Surg 1998, 64: 471-475.","journal-title":"Am Surg"},{"key":"7163_CR3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/000313480206800115","volume":"68","author":"MM Puc","year":"2002","unstructured":"Puc MM, Tran HS, Wry PW, Ross SE: Ultrasound is not a useful screening tool for acute acalculous cholecystitis in critically ill trauma patients.\n                           Am Surg 2002, 68: 65-69.","journal-title":"Am Surg"},{"key":"7163_CR4","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/01.ccx.0000235211.79236.83","volume":"12","author":"M Crandall","year":"2006","unstructured":"Crandall M, West MA: Evaluation of the abdomen in the critically ill patient: opening the black box.\n                           Curr Opin Crit Care 2006, 12: 333-339. 10.1097\/01.ccx.0000235211.79236.83","journal-title":"Curr Opin Crit Care"},{"key":"7163_CR5","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1007\/s00464-003-9004-1","volume":"17","author":"T Hackert","year":"2003","unstructured":"Hackert T, Kienle P, Weitz J, Werner J, Szabo G, Hagl S, Buchler MW, Schmidt J: Accuracy of diagnostic laparoscopy for early diagnosis of abdominal complications after cardiac surgery.\n                           Surg Endosc 2003, 17: 1671-1674. 10.1007\/s00464-003-9004-1","journal-title":"Surg Endosc"},{"key":"7163_CR6","doi-asserted-by":"publisher","first-page":"S208","DOI":"10.1097\/01.CCM.0000260632.01170.1F","volume":"35","author":"HP Wang","year":"2007","unstructured":"Wang HP, Chen SC: Upper abdominal ultrasound in the critically ill.\n                           Crit Care Med 2007, 35: S208-215. 10.1097\/01.CCM.0000260632.01170.1F","journal-title":"Crit Care Med"},{"key":"7163_CR7","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/S0749-0704(05)70099-3","volume":"16","author":"CG Rehm","year":"2000","unstructured":"Rehm CG: Bedside laparoscopy.\n                           Crit Care Clin 2000, 16: 101-112. 10.1016\/S0749-0704(05)70099-3","journal-title":"Crit Care Clin"},{"key":"7163_CR8","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1007\/s004640000371","volume":"15","author":"AP Pecoraro","year":"2001","unstructured":"Pecoraro AP, Cacchione RN, Sayad P, Williams ME, Ferzli GS: The routine use of diagnostic laparoscopy in the intensive care unit.\n                           Surg Endosc 2001, 15: 638-641. 10.1007\/s004640000371","journal-title":"Surg Endosc"},{"key":"7163_CR9","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1067\/msy.2002.122607","volume":"131","author":"DJ Gagne","year":"2002","unstructured":"Gagne DJ, Malay MB, Hogle NJ, Fowler DL: Bedside diagnostic minilaparoscopy in the intensive care patient.\n                           Surgery 2002, 131: 491-496. 10.1067\/msy.2002.122607","journal-title":"Surgery"},{"key":"7163_CR10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s00464-008-0103-x","volume":"23","author":"D Stefanidis","year":"2009","unstructured":"Stefanidis D, Richardson WS, Chang L, Earle DB, Fanelli RD: The role of diagnostic laparoscopy for acute abdominal conditions: an evidence-based review.\n                           Surg Endosc 2009, 23: 16-23. 10.1007\/s00464-008-0103-x","journal-title":"Surg Endosc"},{"key":"7163_CR11","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/00003246-198505000-00001","volume":"13","author":"JA Savino","year":"1985","unstructured":"Savino JA, Scalea TM, Del Guercio LR: Factors encouraging laparotomy in acalculous cholecystitis.\n                           Crit Care Med 1985, 13: 377-380. 10.1097\/00003246-198505000-00001","journal-title":"Crit Care Med"},{"key":"7163_CR12","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1007\/BF00594100","volume":"7","author":"CP Brandt","year":"1993","unstructured":"Brandt CP, Priebe PP, Eckhauser ML: Diagnostic laparoscopy in the intensive care patient. Avoiding the nontherapeutic laparotomy.\n                           Surg Endosc 1993, 7: 168-172. 10.1007\/BF00594100","journal-title":"Surg Endosc"},{"key":"7163_CR13","first-page":"686","volume":"105","author":"TJ Iberti","year":"1989","unstructured":"Iberti TJ, Salky BA, Onofrey D: Use of bedside laparoscopy to identify intestinal ischemia in postoperative cases of aortic reconstruction.\n                           Surgery 1989, 105: 686-689.","journal-title":"Surgery"},{"key":"7163_CR14","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1007\/BF02498865","volume":"6","author":"JS Bender","year":"1992","unstructured":"Bender JS, Talamini MA: Diagnostic laparoscopy in critically ill intensive-care-unit patients.\n                           Surg Endosc 1992, 6: 302-304. 10.1007\/BF02498865","journal-title":"Surg Endosc"},{"key":"7163_CR15","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/BF02498806","volume":"6","author":"KA Forde","year":"1992","unstructured":"Forde KA, Treat MR: The role of peritoneoscopy (laparoscopy) in the evaluation of the acute abdomen in critically ill patients.\n                           Surg Endosc 1992, 6: 219-221. 10.1007\/BF02498806","journal-title":"Surg Endosc"},{"key":"7163_CR16","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1007\/BF00642431","volume":"8","author":"CP Brandt","year":"1994","unstructured":"Brandt CP, Priebe PP, Jacobs DG: Value of laparoscopy in trauma ICU patients with suspected acute acalculous cholecystitis.\n                           Surg Endosc 1994, 8: 361-364. discussion 364\u2013365 10.1007\/BF00642431","journal-title":"Surg Endosc"},{"key":"7163_CR17","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1089\/lps.1995.5.227","volume":"5","author":"J Almeida","year":"1995","unstructured":"Almeida J, Sleeman D, Sosa JL, Puente I, McKenney M, Martin L: Acalculous cholecystitis: the use of diagnostic laparoscopy.\n                           J Laparoendosc Surg 1995, 5: 227-231.","journal-title":"J Laparoendosc Surg"},{"key":"7163_CR18","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1007\/s004649900532","volume":"11","author":"R Orlando 3rd","year":"1997","unstructured":"Orlando R 3rd, Crowell KL: Laparoscopy in the critically ill.\n                           Surg Endosc 1997, 11: 1072-1074. 10.1007\/s004649900532","journal-title":"Surg Endosc"},{"key":"7163_CR19","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1007\/s004649900869","volume":"12","author":"RM Walsh","year":"1998","unstructured":"Walsh RM, Popovich MJ, Hoadley J: Bedside diagnostic laparoscopy and peritoneal lavage in the intensive care unit.\n                           Surg Endosc 1998, 12: 1405-1409. 10.1007\/s004649900869","journal-title":"Surg Endosc"},{"key":"7163_CR20","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s004640010068","volume":"14","author":"JJ Kelly","year":"2000","unstructured":"Kelly JJ, Puyana JC, Callery MP, Yood SM, Sandor A, Litwin DE: The feasibility and accuracy of diagnostic laparoscopy in the septic ICU patient.\n                           Surg Endosc 2000, 14: 617-621. 10.1007\/s004640010068","journal-title":"Surg Endosc"},{"key":"7163_CR21","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1089\/109264201317054618","volume":"11","author":"D Rosin","year":"2001","unstructured":"Rosin D, Haviv Y, Kuriansky J, Segal E, Brasesco O, Rosenthal RJ, Shabtai M, Ayalon A: Bedside laparoscopy in the ICU: report of four cases.\n                           J Laparoendosc Adv Surg Tech A 2001, 11: 305-309. 10.1089\/109264201317054618","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"7163_CR22","first-page":"155","volume":"10","author":"EJ Jaramillo","year":"2006","unstructured":"Jaramillo EJ, Trevino JM, Berghoff KR, Franklin ME Jr: Bedside diagnostic laparoscopy in the intensive care unit: a 13-year experience.\n                           JSLS 2006, 10: 155-159.","journal-title":"JSLS"},{"key":"7163_CR23","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1097\/01.CCM.0000104917.39204.0A","volume":"32","author":"J Warren","year":"2004","unstructured":"Warren J, Fromm RE Jr, Orr RA, Rotello LC, Horst HM: Guidelines for the inter- and intrahospital transport of critically ill patients.\n                           Crit Care Med 2004, 32: 256-262. 10.1097\/01.CCM.0000104917.39204.0A","journal-title":"Crit Care Med"},{"key":"7163_CR24","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1016\/j.athoracsur.2006.05.093","volume":"82","author":"JH Khan","year":"2006","unstructured":"Khan JH, Lambert AM, Habib JH, Broce M, Emmett MS, Davis EA: Abdominal complications after heart surgery.\n                           Ann Thorac Surg 2006, 82: 1796-1801. 10.1016\/j.athoracsur.2006.05.093","journal-title":"Ann Thorac Surg"},{"key":"7163_CR25","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1111\/j.0001-5172.2004.00426.x","volume":"48","author":"J Laurila","year":"2004","unstructured":"Laurila J, Syrjala H, Laurila PA, Saarnio J, Ala-Kokko TI: Acute acalculous cholecystitis in critically ill patients.\n                           Acta Anaesthesiol Scand 2004, 48: 986-991. 10.1111\/j.0001-5172.2004.00426.x","journal-title":"Acta Anaesthesiol Scand"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc7730.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/cc7730\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc7730.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:42:50Z","timestamp":1728304970000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/cc7730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,2,25]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2009,2]]}},"alternative-id":["7163"],"URL":"https:\/\/doi.org\/10.1186\/cc7730","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,2,25]]},"assertion":[{"value":"11 October 2008","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2009","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2009","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R25"}}