Purpose: Acute gangrenous and perforated appendicitis are associated
with an increased risk for intraoperative conversion, postoperative
complications and have been considered a relative contraindication for
laparoscopic appendectomy. The objective of this study was to analyze the
feasibility of the laparoscopic approach in all forms of appendicitis.
Methods: A retrospective review of 101 patients who underwent
laparoscopic appendectomy for uncomplicated and complicated appendicitis
(perforated appendicitis and periappendiceal abscess) between June 2000 and
May 2001 was performed. Results: There were 84 patients with
uncomplicated appendicitis (group A), 11 patients with perforated
appendicitis (group B) and 16 patients with periappendiceal abscess (group
C). The mean age of the patients was 42 (12∼79) years and there were 47 men
and 54 women. The mean operation time was 43, 67 and 105 minutes in groups
A, B and C, respectively. Oral intake commenced at 1.4, 2.2 and 2.9 days and
the hospital stay was 2.5, 2.9 and 5.2 days in groups A, B and C,
respectively. There was no conversion to open surgery in groups A and B;
however 4 patients in group C were converted. Complications were noted in 3
patients, one for each group. The overall complication rate was 2.9% and
conversion rate, 0.9%. Conclusion: Although our experience is
limited, the laparoscopic appendectomy seems to be a feasible and safe
procedure for all forms of apppendicitis, including periappendiceal abscess.
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