Surgical Intervention on Early Postoperative Small Bowel Obstructions

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Eary postoperative small bowel obstruction (EPSBO) poses a unique challenge in the field of abdominal surgery due to difficulties in diagnosis and management related to the timing of its presentation. Due to concerns regarding early postoperative adhesions and the potential for intraoperative complications, traditional strategies have focused on conservative management with bowel rest and decompression. Previous studies have demonstrated that observation, which may last for weeks and require TPN, is safe and effective in the majority of cases. However, this watchful waiting time can drastically affect a patient's hospital length of stay and quality of life. Here, we evaluate the courses of 15 consecutive EPSBO patients at Butterworth Hospital who underwent surgical intervention, with an emphasis on the operative approach, intra-operative findings, and postoperative challenges.

This retrospective study was performed using data from the Corewell Health Butterworth acute care surgery registry. The registry was queried to identify patients who were admitted to Butterworth Hospital and underwent surgery for a small bowel obstruction from January 1, 2020 to July 31, 2025. Electronic medical records were then accessed to create a final list of 15 patients who had been diagnosed within 30 days of prior abdominal surgery. Hospital courses were reviewed by the study team in order to meet the objectives. The primary aim was to describe the perioperative courses and outcomes for these patients who had undergone an operation for an EPSBO. Secondary aims were to identify trends in surgical histories, time since prior operation, intra-operative findings, hospital length of stay (HLOS), and postoperative challenges. Summary statistics were performed for this descriptive study due to the small sample size and nature of the study.

In total, 15 patients were included in the study. The average time since last abdominal surgery was 9.4 days (median 9.0 days), and in 46.7% of cases the prior surgery had involved lysis of adhesions for an adhesive small bowel obstruction. 46.7% had failed a Gastrografin challenge prior undergoing surgery. The operative approach was robot-assisted for one case (6.7%), traditional laparoscopy for 13.3%, and open laparotomy for 80%. In 60% of cases for EPSBO, no serosal tears or full-thickness enterotomies were reported, while 33.3% were complicated by serosal tears that were identified intraoperatively and imbricated. In 13.3% of operations, inadvertent full-thickness enterotomies occurred and required small bowel resections. Mean total HLOS was 20.5 days (median 15.4 days), and mean time from surgery to discharge was 1.9 days (median 11.0 days). Overall, no in-hospital mortalities occurred in this cohort, and no patient was discharged home with hospice. 80% of patients were ultimately discharged home.

This retrospective study suggests that surgical intervention for EPSBOs can be performed safely and effectively in carefully selected patients. In this series, there were no recorded mortalities, and the majority of operations occurred without significant complication. It is likely that operative management of EPSBOs can decrease HLOS and time to enteral nutrition. Future studies should directly compare EPSBO cohorts based on early operative versus non-operative management.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2094

This document is currently not available here.

Share

COinS