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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Morbidity of laparoscopic surgery for complicated appendicitis: an international study
J Cueto1, B D'Allemagne, J A Vázquez-Frias
1Department of Surgery, Hospitals ABC y Angeles Lomas, Mexico City, Mexico. cuetoj@prodigy.net.mx
Background:
Although laparoscopic appendectomy has some advantages over open appendectomy, some reports do show more postoperative intraabdominal abscesses.
Methods:
A retrospective review of complicated appendicitis managed surgically by eight surgical groups from six countries was undertaken. Among 3,433 patients with appendicitis, 1,017 (29.5%) had complicated appendicitis, which included perforated or gangrenous appendicitis with or without localized or disseminated peritonitis. There were 74 preoperative abscesses (7.4%) and 5 small bowel obstructions.
Results:
One patient died. There were 29 postoperative intraabdominal abscesses (2.8%) and 112 mostly minor complications. Conversion to laparotomy was necessary for 28 patients (2.7%). The surgical time ranged from 32 to 132 min (mean, 62 min), and the hospital stay ranged from 1 to 18 days (mean, 3.5 days).
Conclusions:
The morbidity rates, particularly for intraabdominal abscesses, were less for laparoscopic appendectomy in complicated appendicitis than those reported in the literature for open appendectomy, whereas operating times and hospital stays were similar.
Insights
Laparoscopic appendectomy for complicated appendicitis showed lower rates of intraabdominal abscesses compared to open surgery. Operating times and hospital stays were similar, suggesting improved outcomes with the laparoscopic approach.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic appendectomy offers advantages over open appendectomy.
- Concerns exist regarding increased postoperative intraabdominal abscesses with laparoscopic procedures.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic appendectomy in complicated appendicitis.
- To compare complication rates, operating times, and hospital stays with historical data for open appendectomy.
Main Methods:
- Retrospective review of 3,433 appendicitis patients, with 1,017 having complicated appendicitis.
- Data collected from eight surgical groups across six countries.
- Inclusion criteria: perforated or gangrenous appendicitis with or without peritonitis.
Main Results:
- A total of 29 postoperative intraabdominal abscesses (2.8%) were observed.
- Conversion to laparotomy occurred in 2.7% of cases.
- Mean operating time was 62 minutes, and mean hospital stay was 3.5 days.
Conclusions:
- Laparoscopic appendectomy demonstrated lower morbidity, specifically for intraabdominal abscesses, in complicated appendicitis compared to open appendectomy.
- Operating times and hospital stays were comparable between the two approaches.
- Laparoscopic approach is a viable and potentially safer option for complicated appendicitis.
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