• Ferdinando Agresta, Luca Ansaloni, Gian Luca Baiocchi, Carlo Bergamini, Fabio Cesare Campanile, Michele Carlucci, Giafranco Cocorullo, Alessio Corradi, Boris Franzato, Massimo Lupo, Vincenzo Mandalà, Antonino Mirabella, Graziano Pernazza, Micaela Piccoli, Carlo Staudacher, Nereo Vettoretto, Mauro Zago, Emanuele Lettieri, Anna Levati, Domenico Pietrini, Mariano Scaglione, Salvatore De Masi, Giuseppe De Placido, Marsilio Francucci, Monica Rasi, Abe Fingerhut, Selman Uranüs, and Silvio Garattini.
• Department of General Surgery, Presidio Ospedaliero di Adria, Piazza degli Etruschi, 9, 45011 Adria, RO, Italy. fagresta@libero.it
• Surg Endosc. 2012 Aug 1;26(8):2134-64.

BackgroundIn January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases.MethodsOther Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association. In November 2010, the panel met in Rome to discuss each chapter according to the Delphi method, producing key statements with a grade of recommendations followed by commentary to explain the rationale and the level of evidence behind the statements. Thereafter, the statements were presented to the Annual Congress of the EAES in June 2011.ResultsA thorough literature review was necessary to assess whether the recommendations issued in 2006 are still current. In many cases new studies allowed us to better clarify some issues (such as for diverticulitis, small bowel obstruction, pancreatitis, hernias, trauma), to confirm the key role of laparoscopy (such as for cholecystitis, gynecological disorders, nonspecific abdominal pain, appendicitis), but occasionally previous strong recommendations have to be challenged after review of recent research (such as for perforated peptic ulcer).ConclusionsEvery surgeon has to develop his or her own approach, taking into account the clinical situation, her/his proficiency (and the experience of the team) with the various techniques, and the specific organizational setting in which she/he is working. This guideline has been developed bearing in mind that every surgeon could use the data reported to support her/his judgment.

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