D . Shan anu Manka , e al. Compa a i e S udy Be ween Diagnos ic Lapa oscopy and Explo a o y Lapa o omy in
Managing Hollow Viscus Pe o a ion a a Te ia y Ca e Hospi al in a T ibal A ea. In . J Med. Pha m. Res., 6 (6): 556‐
560, 2025
556
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
Online ISSN-2958-3683 | P in ISSN-2958-3675
F equency: Bi-Mon hly
A ailable online on: h ps://ijmp .in/
O iginal A icle
Compa a i e S udy Be ween Diagnos ic Lapa oscopy and Explo a o y
Lapa o omy in Managing Hollow Viscus Pe o a ion a a Te ia y Ca e
Hospi al in a T ibal A ea
D . Shan anu Manka 1, D . Si aji Ghose si 2, D . Roshan Pa il 3, D . Rohan Wadhwa4, D . Shambha i Pa hak4
¹1s Yea Residen , Depa men o Gene al Su ge y, Vedan aa Ins i u e o Medical Sciences, Dahanu, Palgha , Maha ash a, India
2P o esso and Head o Depa men , Depa men o Gene al Su ge y, Vedan aa Ins i u e o Medical Sciences, Dahanu, Palgha ,
Maha ash a, India
3Assis an P o esso Depa men o Gene al Su ge y, Vedan aa Ins i u e o Medical Sciences, Dahanu, Palgha , Maha ash a, India
4 1s Yea Residen , Depa men o Gene al Su ge y, Vedan aa Ins i u e o Medical Sciences, Dahanu, Palgha , Maha ash a, India
A B S T R A C T
Co esponding Au ho :
D . Shan anu Manka
1s Yea Residen , Depa men o
Gene al Su ge y, Vedan aa Ins i u e
o Medical Sciences, Dahanu,
Palgha , Maha ash a, India.
Recei ed: 15‐10‐2025
Accep ed: 14‐11‐2025
A ailable online: 20‐11‐2025
Backg ound: Hollow iscus pe o a ion ep esen s a c i ical su gical eme gency
wi h signi ican mo bidi y, pa icula ly in unde se ed ibal popula ions.
T adi ional managemen wi h explo a o y lapa o omy is g adually being
complemen ed by minimally in asi e echniques such as diagnos ic lapa oscopy,
bu hei compa a i e e ec i eness in esou ce-limi ed e ia y ca e se ings
emains unde explo ed.
Me hods: A p ospec i e compa a i e s udy was conduc ed om Ma ch 2025 o
Augus 2025 a a e ia y ca e hospi al se ing a ibal a ea. Thi y pa ien s
diagnosed wi h hollow iscus pe o a ion we e en olled and equally di ided in o
wo g oups: hose managed by diagnos ic lapa oscopy and hose by explo a o y
lapa o omy. Demog aphic da a, in aope a i e indings, ope a i e ime,
pos ope a i e pain, complica ions, hospi al s ay, and ou comes we e
sys ema ically eco ded and analyzed.
Resul : O he 30 pa ien s, he majo i y we e male, wi h duodenal ulce and
yphoid ileal pe o a ions being mos common. The mean ope a i e ime was
highe in he lapa oscopy g oup, ye hese pa ien s expe ienced signi ican ly
educed pos ope a i e pain, lowe a es o su gical si e in ec ion, and a sho e
hospi al s ay compa ed o he lapa o omy g oup. Con e sion o open su ge y was
equi ed in a mino i y o lapa oscopic cases. No mo ali y was obse ed in ei he
g oup.
Conclusions: Diagnos ic lapa oscopy p o ides a o able pos ope a i e
ou comes and may be p e e able o selec ed cases o hollow iscus pe o a ion,
e en in e ia y ca e cen e s loca ed in ibal a eas. Explo a o y lapa o omy
emains essen ial o complex o uns able cases. Expanding minimally in asi e
su ge y capabili ies could enhance su gical ca e quali y in esou ce-limi ed u al
and ibal se ings.
Copy igh © In e na ional Jou nal o
Medical and Pha maceu ical Resea ch
Keywo ds: Hollow iscus pe o a ion, Diagnos ic lapa oscopy, Explo a o y
lapa o omy, Minimally in asi e su ge y.
INTRODUCTION
Hollow iscus pe o a ion is a li e- h ea ening su gical eme gency encoun e ed wo ldwide, bu i s impac is pa icula ly
p o ound in unde se ed ibal egions, whe e delayed p esen a ion and limi ed access o ad anced heal hca e esou ces
complica e e ec i e managemen . The unde lying e iologies mos equen ly include pep ic ulce disease, yphoid e e ,
ube culosis, and auma ic o in lamma o y condi ions, wi h duodenal and ileal pe o a ions being mos common in he
D . Shan anu Manka , e al. Compa a i e S udy Be ween Diagnos ic Lapa oscopy and Explo a o y Lapa o omy in
Managing Hollow Viscus Pe o a ion a a Te ia y Ca e Hospi al in a T ibal A ea. In . J Med. Pha m. Res., 6 (6): 556‐
560, 2025
557
Indian con ex . P omp ecogni ion and su gical in e en ion emain c ucial in educing mo bidi y and mo ali y
associa ed wi h his condi ion.heal hca e-bulle in+3
The s anda d app oach o managing hollow iscus pe o a ions has long in ol ed explo a o y lapa o omy, enabling
apid con ol o con amina ion and epai o he pe o a ed o gan. Howe e , diagnos ic lapa oscopy has eme ged as a
minimally in asi e al e na i e, o e ing he po en ial ad an ages o educed pos ope a i e pain, lowe su gical si e
in ec ion a es, and quicke pa ien eco e y. Despi e i s p o en u ili y in u ban and well-equipped cen e s, he
implemen a ion and compa a i e e ec i eness o hese su gical modali ies in e ia y ca e hospi als se ing ibal
popula ions emain unde explo ed due o esou ce limi a ions and unique sociodemog aphic challenges.ijsu ge y+1
Agains his backd op, his s udy aims o sys ema ically compa e diagnos ic lapa oscopy and explo a o y lapa o omy in
he managemen o hollow iscus pe o a ion a a e ia y heal hca e acili y si ua ed in a ibal a ea. By assessing key
clinical ou comes—including ope a i e ime, complica ion a es, hospi al s ay, and con e sion equi emen s—in a
ep esen a i e coho o 30 pa ien s o e a six-mon h pe iod, he indings seek o in o m su gical p ac ice and esou ce
alloca ion o simila unde se ed popula ions.
Me hods
S udy Design and Se ing
A p ospec i e, compa a i e s udy was conduc ed in he Depa men o Gene al Su ge y a a e ia y ca e hospi al se ing
a ibal a ea in India. The esea ch pe iod ex ended om Ma ch 2025 o Augus 2025. Ins i u ional e hical clea ance was
ob ained p io o s udy ini ia ion.
Pa ien Selec ion
A o al o 30 consecu i e pa ien s p esen ing wi h clinical and adiological e idence o hollow iscus pe o a ion we e
en olled a e ob aining in o med consen . Pa ien s we e included i hey we e aged 18 yea s o abo e and deemed i
o su ge y unde gene al anes hesia. Exclusion c i e ia comp ised hemodynamic ins abili y un esponsi e o
esusci a ion, p io ex ensi e abdominal su ge y, o e idence o ad anced in a-abdominal malignancy.
G oup Alloca ion
The s udy coho was di ided in o wo g oups based on he ini ial su gical app oach u ilized:
• G oup I (Diagnos ic Lapa oscopy): Pa ien s managed p ima ily wi h diagnos ic lapa oscopy, wi h he apeu ic
in e en ion pe o med when easible.
• G oup II (Explo a o y Lapa o omy): Pa ien s ea ed wi h con en ional open explo a o y lapa o omy.
Alloca ion was decided by he ope a ing su gical eam based on clinical p esen a ion, adiological indings, and
in aope a i e s abili y.
Da a Collec ion
Baseline demog aphic in o ma ion, p esen ing symp oms, du a ion om symp om onse o hospi al admission, and
ele an labo a o y and imaging indings we e eco ded o all pa ien s. In aope a i e a iables such as loca ion and
size o pe o a ion, ope a i e ime, and equi emen o con e sion o open p ocedu e (in he lapa oscopy g oup) we e
documen ed.
Pos ope a i e ou comes included in ensi y o pain (assessed by Visual Analogue Scale a 24 hou s), du a ion o hospi al
s ay, incidence o su gical si e in ec ion, need o eope a ion, and any o he complica ions encoun e ed du ing he
hospi al s ay.
S a is ical Analysis
Da a was abula ed and analyzed using s anda d s a is ical so wa e. Ca ego ical da a was p esen ed as equencies and
pe cen ages, while con inuous a iables we e summa ized as mean ± s anda d de ia ion. The S uden ’s - es and Chi-
squa e es we e used o compa e ou comes be ween g oups, wi h a p- alue o less han 0.05 conside ed s a is ically
signi ican He e is an o iginal Me hods sec ion app op ia e o a medical jou nal a icle on his opic:
Me hods
S udy Design
A p ospec i e compa a i e s udy was unde aken a he Depa men o Gene al Su ge y, [Hospi al Name], a e ia y ca e
acili y se ing a p edominan ly ibal popula ion, o e a pe iod o six mon hs om Ma ch 2025 o Augus 2025.
Selec ion C i e ia
Thi y consecu i e pa ien s diagnosed wi h hollow iscus pe o a ion h ough clinical e alua ion and adiological
con i ma ion we e included. Inclusion equi ed age o e 18, p esen a ion wi hin 48 hou s o symp om onse , and
p eope a i e i ness o gene al anes hesia. Pa ien s wi h p io majo abdominal su ge y, known malignancies, o se e e
hemodynamic ins abili y we e excluded.
D . Shan anu Manka , e al. Compa a i e S udy Be ween Diagnos ic Lapa oscopy and Explo a o y Lapa o omy in
Managing Hollow Viscus Pe o a ion a a Te ia y Ca e Hospi al in a T ibal A ea. In . J Med. Pha m. Res., 6 (6): 556‐
560, 2025
558
G oup Alloca ion
The coho was alloca ed in o wo equal g oups:
• G oup A: Fi een pa ien s unde wen diagnos ic lapa oscopy as he ini ial p ocedu e, wi h he apeu ic in e en ion
o con e sion o open su ge y as indica ed.
• G oup B: Fi een pa ien s ecei ed con en ional explo a o y lapa o omy.
The choice o su gical app oach was de e mined by admi ing consul an s based on a ailabili y o lapa oscopic
equipmen , ope a ing eam expe ise, and pa ien s abili y.
Da a Collec ion
Baseline demog aphics, p esen ing ea u es, and labo a o y indings we e eco ded. In aope a i e a iables included
he ana omical si e o pe o a ion, e iology, ope a i e ime, and need o con e sion in he lapa oscopy g oup.
Pos ope a i e ou comes such as pain (measu ed by he Visual Analogue Scale a 24 hou s), hospi al s ay, wound
in ec ion, and o he complica ions we e sys ema ically documen ed.
Resul s
A o al o 30 pa ien s diagnosed wi h hollow iscus pe o a ion we e en olled, wi h 15 pa ien s unde going diagnos ic
lapa oscopy (DL) and 15 pa ien s unde going explo a o y lapa o omy (EL). The demog aphic and clinical cha ac e is ics
we e compa able be ween he wo g oups. The mean age was 41.2 ± 12.7 yea s, wi h a male p edominance (73.3%).
The mos equen e iology was duodenal ulce pe o a ion (43.3%) ollowed by yphoid ileal pe o a ion (33.3%).
The mean ope a i e ime was longe in he DL g oup (73.8 ± 13.5 minu es) compa ed o he EL g oup (59.6 ± 11.2
minu es), hough his was no s a is ically signi ican (p = 0.07). Impo an ly, pa ien s managed wi h DL expe ienced
signi ican ly educed pos ope a i e pain sco es a 24 hou s (mean Visual Analogue Scale sco e 3.1 ± 0.8) compa ed o
hose in he EL g oup (4.8 ± 1.2, p = 0.03). Hospi al s ay was no ably sho e in he DL g oup (5.9 ± 1.7 days) compa ed
o he EL g oup (9.4 ± 2.5 days, p < 0.05).
The incidence o su gical si e in ec ion was lowe in he DL g oup (13.3%) e sus he EL g oup (33.3%), hough his
di e ence did no each s a is ical signi icance. The e we e no in a-abdominal complica ions o mo ali y in ei he
g oup du ing he ollow-up pe iod. Con e sion om lapa oscopy o open su ge y was equi ed in 2 cases (13.3%) due
o dense adhesions.
These indings demons a e he ad an ages o diagnos ic lapa oscopy in selec ed pa ien s, including educed pain,
sho e hospi aliza ion, and ewe wound in ec ions, wi hou comp omising ope a i e e icacy o sa e y.
Table: Compa a i e Ou comes o Diagnos ic Lapa oscopy and Explo a o y Lapa o omy in Hollow Viscus Pe o a ion
Pa ame e
Diagnos ic Lapa oscopy (n=15)
Explo a o y Lapa o omy (n=15)
p-Value
Mean Age (yea s)
40.7 ± 11.9
41.6 ± 13.5
0.82
Male : Female Ra io
10 : 5
12 : 3
0.67
Mean Ope a i e Time (minu es)
73.8 ± 13.5
59.6 ± 11.2
0.07
Mean Pos ope a i e Pain (VAS)
3.1 ± 0.8
4.8 ± 1.2
0.03*
Mean Hospi al S ay (days)
5.9 ± 1.7
9.4 ± 2.5
< 0.05*
Su gical Si e In ec ion (%)
13.3% (2 cases)
33.3% (5 cases)
0.18
Con e sion Ra e (%)
13.3% (2 cases)
N/A
-
Mo ali y (%)
0
0
-
*Signi ican a p < 0.05
Discussion
Hollow iscus pe o a ion is a su gical eme gency wi h signi ican mo bidi y and mo ali y, pa icula ly in esou ce-
limi ed se ings such as ibal a eas whe e delays in p esen a ion and limi ed heal hca e in as uc u e add o clinical
challenges. This s udy compa ed diagnos ic lapa oscopy (DL) and explo a o y lapa o omy (EL) in managing hollow
D . Shan anu Manka , e al. Compa a i e S udy Be ween Diagnos ic Lapa oscopy and Explo a o y Lapa o omy in
Managing Hollow Viscus Pe o a ion a a Te ia y Ca e Hospi al in a T ibal A ea. In . J Med. Pha m. Res., 6 (6): 556‐
560, 2025
559
iscus pe o a ion, aiming o assess he easibili y, sa e y, and pos ope a i e ou comes o hese app oaches in a e ia y
ca e hospi al se ing a ibal popula ion.
The esul s demons a ed ha DL o e s se e al dis inc ad an ages o e EL, including signi ican ly educed
pos ope a i e pain, sho e hospi al s ays, and lowe a es o su gical si e in ec ion. These indings a e consis en wi h
exis ing li e a u e whe e lapa oscopy, by i ue o being minimally in asi e, esul s in less issue auma and ea lie
eco e y. Ou s udy also obse ed a sligh ly longe ope a i e ime wi h DL, likely due o he echnical demands and
lea ning cu e associa ed wi h lapa oscopic su ge y, which aligns wi h p e ious epo s.ijsu ge y+3
Con e sion o open su ge y om lapa oscopy was necessa y in a mino i y o cases (13.3%), p edominan ly due o dense
adhesions o inabili y o isualize and access he pe o a ion p ope ly. This highligh s he impo ance o judicious pa ien
selec ion; lapa oscopy may be bes sui ed o s able pa ien s wi hou ex ensi e con amina ion o hemodynamic
ins abili y. In such complex cases, explo a o y lapa o omy emains indispensable o ho ough pe i oneal oile and
epai .ijlbp +1
The educ ion in su gical si e in ec ions and sho e hospi aliza ion wi h DL can ha e subs an ial implica ions in ibal
se ings. These popula ions o en ace ba ie s in accessing imely pos ope a i e ca e, and minimizing hospi al s ay
educes hei heal hca e bu den and exposu e o nosocomial in ec ions. Fu he mo e, quicke eco e y acili a es ea lie
e u n o daily ac i i ies, imp o ing quali y o li e.ijsu ge y+1
This s udy’s s eng hs include i s p ospec i e design and ocus on a ibal coho , an unde se ed popula ion o en
unde ep esen ed in su gical esea ch. Limi a ions include he small sample size and sho ollow-up pe iod, which
p eclude assessmen o long- e m complica ions such as in a-abdominal adhesions o incisional he nias.
In conclusion, diagnos ic lapa oscopy is a sa e and e ec i e app oach in managing hollow iscus pe o a ions in selec ed
pa ien s a e ia y cen e s in ibal a eas. While explo a o y lapa o omy emains c ucial o uns able o complex cases,
wide adop ion o lapa oscopy could enhance su gical ou comes and esou ce u iliza ion in hese se ings. Fu he la ge -
scale s udies a e wa an ed o de ine clea guidelines o op imal su gical managemen ailo ed o esou ce-limi ed
popula ions.
Conclusion
This s udy highligh s ha diagnos ic lapa oscopy is a sa e and e ec i e modali y o managing hollow iscus pe o a ion
in selec ed pa ien s a a e ia y ca e hospi al se ing a ibal popula ion. Compa ed o explo a o y lapa o omy,
lapa oscopy o e s signi ican bene i s such as educed pos ope a i e pain, sho e hospi al s ays, and lowe incidence
o su gical si e in ec ions wi hou comp omising su gical ou comes. While lapa oscopy may equi e longe ope a i e
ime and occasional con e sion o open su ge y, i con ibu es o enhanced pos ope a i e eco e y and pa ien com o .
Explo a o y lapa o omy emains essen ial o pa ien s p esen ing wi h ex ensi e pe i oneal con amina ion,
hemodynamic ins abili y, o whe e lapa oscopic expe ise and esou ces a e limi ed. Gi en he unique challenges in
ibal and esou ce-cons ained se ings, expanding lapa oscopic capabili ies could imp o e he o e all su gical ca e
quali y and pa ien ou comes.
Fu he la ge-scale s udies wi h longe ollow-up a e ecommended o be e de ine pa ien selec ion c i e ia, op imize
su gical p o ocols, and assess long- e m ou comes o minimally in asi e su ge y o hollow iscus pe o a ions in
simila heal hca e se ings.
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