Laparoscopic appendectomy: a review of 95 consecutive suspected cases of appendicitis

Abstract

Objective: To assess the feasibility and efficacy of laparoscopic appendectomy.

Design: A review of a case series.

Setting: A single teaching and referral centre in Vancouver.

Patients: Ninety-five consecutive patients referred to the Division of General Surgery with suspected appendicitis requiring surgical intervention. The patients ranged in age from 15 to 85 years.

Interventions: Laparoscopic appendectomy or open appendectomy.

Main outcome measures: Feasibility of laparoscopic appendectomy, duration of operation, intraoperative and postoperative complications and duration of postoperative hospital stay.

Results: Of the 95 patients, 9 had contraindications to laparoscopic appendectomy and underwent an open operation. Of the 86 patients who underwent laparoscopy, the diagnosis of appendicitis was confirmed in 69 (80%). Following this, 61 (88%) patients underwent laparoscopic appendectomy, and in 8 the procedure was converted to open appendectomy because of periappendiceal abscess or an immobile or perforated appendix. The mean duration of operation was 78.5 minutes. There were no intraoperative complications. The mean duration of postoperative hospital stay was 2.8 days. Postoperative complications consisted of ileus in two patients and diarrhea in two patients. There were no wound infections.

Conclusions: Laparoscopic appendectomy can be performed safely, with minimal complications on most patients with appendicitis; hospital stay is reduced. Laparoscopy allows accurate diagnosis.