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Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective
B P Mao1,2, G Collins3,4, F E Ayeni5
1Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. brooke.mao@health.nsw.gov.au.
Langenbeck'S Archives of Surgery
|August 9, 2024
Summary
Elevated C-reactive protein (CRP) on admission may predict intra-abdominal abscess (IAA) after appendicectomy. Appendiceal perforation also increases IAA risk, while prolonged antibiotics do not appear to influence IAA development or washout needs.
Area of Science:
- General Surgery
- Gastroenterology
- Infectious Disease
Background:
- Laparoscopic appendicectomy is a common procedure for acute appendicitis in Australia.
- Intra-abdominal abscess (IAA) is a known complication, but risk factors are poorly defined.
- Laparoscopic washout may be necessary for managing complications like IAA.
Purpose of the Study:
- To identify risk factors for developing post-operative IAA after laparoscopic appendicectomy.
- To determine predictors for patients requiring laparoscopic washout for IAA.
Main Methods:
- Analysis of data from 423 patients undergoing laparoscopic appendicectomy (2012-2017).
- Inclusion of clinical, biochemical, radiological, and operative factors.
- Statistical analysis of pre-, peri-, and post-operative data.
Main Results:
- 5.4% of patients developed post-operative IAA.
- Elevated C-reactive protein (CRP) on admission and appendiceal perforation were significant predictors of IAA and need for washout.
- No clinical or radiological findings predicted IAA development or the need for washout.
Conclusions:
- Elevated admission CRP may predict IAA formation or need for laparoscopic washout post-appendicectomy.
- Prolonged post-operative antibiotic use is independent of IAA development and washout requirements.
- Clear guidelines for peri-operative antibiotic use following appendicectomy are needed.
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