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from Section 3 - Passing the Gas
Published online by Cambridge University Press: 09 June 2025
Emergency laparotomy is an extension of the principles outlined in chapter 23. However,
patients presenting for emergency laparotomy have historically had poor outcomes due to a number of factors such as delay in surgery, imaging and antibiotics, poorly supervised junior staff, poor monitoring and low numbers of intensive care beds to deliver postoperative care. Many of these issues have been addressed and morbidity and mortality as fallen substantially.
Perioperatively these patients may have ongoing significant physiological derangement requiring fluids, blood, and inotropes, as well as high inspired oxygen. The use of arterial and central lines is much more common. Patients at high risk may require intensive care postoperatively too.
Multidisciplinary morbidity and mortality meetings are essential to continually drive improvements in care. In addition, for some patients perioperative risk is so high that they may not benefit from surgery.
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