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This study is to investigate the short-term outcomes of small bowel obstruction (SBO) patients undergoing laparoscopic versus open adhesiolysis.A total of 202 patients with SBO were enrolled in this study. The patients underwent either laparoscopic (n=101) or open adhesiolysis (n=101). The primary end point was 30-day overall complications and secondary outcomes included major complications such as superficial and deep wound infections, mortality, postoperative length of stay, and operative time.There was no statistically significant difference in the demographic parameters between laparoscopic and open adhesiolysis populations. The mean operative time for laparoscopic adhesiolysis was significantly less than open adhesiolysis (70±34.2 vs. 101±50.2, P=0.01). Statistically significant differences in flatus day (3.5±1.2 vs. 4.5±1.8, P=0.035) and postoperative hospital stay (6.4±2.1 vs. 7.2±2.9, P=0.041) were identified in favor of laparoscopic group, whereas the medical expenses for both groups were not different (31012.0±3412.9 vs. 30029.0±3100.9, P>0.05). The overall complications for open and laparoscopic group were 19.8% and 9.9%, respectively (P=0.048). The important factors that led to a significantly lower overall complications rate in laparoscopic group might result from the lower wound (9.9% vs. 2.0%, P=0.017) and infectious (10.9% vs. 3.0%, P=0.027) complications.The laparoscopic approach for SBO is feasible because of its fewer complications and hospital stay.