Laparoscopic surgery may significantly lower postoperative complications in patients with strangulated small bowel obstruction (SSBO).

• Complications (Clavien-Dindo grade ≥ II) were 7.4% with laparoscopy versus 29.6% for open surgery (p = 0.036).
• Conversion to open surgery occurred in 25.6% of laparoscopic cases, primarily in those with prior laparotomies or gastrointestinal surgeries.

Surgeons should consider laparoscopic approaches but assess patient history carefully to anticipate the need for conversion.