A four-year experience with laparoscopy in the management of appendicitis

BACKGROUND: The study was conducted to determine the influences of laparoscopy in the management and outcome of patients with appendicitis. METHODS: A retrospective analysis of 154 consecutive patients who were treated for suspected appendicitis. The pre-operative diagnosis included appendicitis, right lower quadrant pain of unknown etiology, and generalized peritonitis. RESULTS: Laparoscopy was used in 108 patients, including 70 laparoscopic appendectomies (LA) and 31 LAs converted to open appendectomy (OA). Forty-six patients had OA. The average operating time for LA was 74.3 minutes and 48.8 minutes with OA. Postoperative complications for LA (7%) included 1 trochar wound hemorrhage, 2 wound infections, and 2 intra-abdominal sepsis; and for OA (9%) were 1 post-operative intra-abdominal hemorrhage, 4 wound infections, 1 wound dehiscence, and 1 intra-abdominal sepsis. Post-operative stay for LA averaged 2.5 days and for OA averaged 4.5 days (P = .0049). LA patients had a considerably faster return to work and/or normal activity than OA patients (P = .00065). CONCLUSIONS: Laparoscopy influenced the management of 29% of patients presenting with suspected appendicitis. LA resulted in shorter hospitalization and a more rapid return to work and/or normal activity than OA.