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.