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Laparoscopic appendectomy for ruptured appendicitis.

C C Yao1, C S Lin, C C Yang

  • 1Department of Surgery, Min-Shen General Hospital, Tao-Yuan, Taiwan, Republic of China.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|June 28, 2000
PubMed
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Laparoscopic appendectomy is feasible for ruptured appendicitis, including cases with local or diffuse peritonitis and selected abscesses. Shorter hospital stays were observed in patients with local peritonitis compared to diffuse peritonitis or abscesses.

Area of Science:

  • Surgical Gastroenterology
  • Minimally Invasive Surgery
  • Emergency Surgery

Background:

  • Appendicitis remains a common surgical emergency.
  • Ruptured appendicitis presents challenges in surgical management.
  • Laparoscopic appendectomy is increasingly adopted for appendicitis.

Purpose of the Study:

  • To assess the feasibility of laparoscopic appendectomy in patients with ruptured appendicitis.
  • To compare outcomes in different presentations of ruptured appendicitis managed laparoscopically.

Main Methods:

  • Retrospective analysis of 328 laparoscopic appendectomies.
  • Focus on 34 cases of pathology-proven ruptured appendicitis.
  • Patients categorized into local peritonitis, diffuse peritonitis, and abscess groups.

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Main Results:

  • Laparoscopic appendectomy was feasible across all groups, with 3 conversions to laparotomy.
  • Symptom duration was longest in the abscess group.
  • Hospital stay was significantly shorter for local peritonitis compared to diffuse peritonitis and abscess groups.
  • No complications or readmissions were reported.

Conclusions:

  • Laparoscopic appendectomy is a feasible surgical option for ruptured appendicitis with local or diffuse peritonitis.
  • Selected cases of ruptured appendicitis with abscess formation can be managed laparoscopically.
  • Further randomized controlled trials are warranted to establish definitive recommendations.