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KMID : 1033220180080020059
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Journal of Acute Care Surgery
2018 Volume.8 No. 2 p.59 ~ p.64
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Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis
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Martin Sean
Wert Yijin
Lyon Zach
Geraci Leonardo
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Abstract
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Purpose: A recent internal review of a community-based hospital system revealed a 19.19% rate of conversion from a laparoscopic appendectomy to an open procedure. This study examined the preoperative risk factors for failed laparoscopic appendectomy requiring a conversion to a laparotomy.
Methods: A total of 198 patients presented with perforated appendicitis. Perforation was defined as a computed tomography (CT) scan interpretation, pathology findings, or surgical findings. Of these patients, 161 underwent a laparoscopic appendectomy or laparoscopy converted to an open procedure. The preoperative risk factors in the two groups were compared through a retrospective chart review.
Results: Through multivariant analysis, age greater than 45 was the greatest risk factor for the need to convert to an open procedure with an odds ratio (OR) of 3.51. A CT scan read of perforation was associated with a significant 2.65 OR. The C-reactive protein was 19.82 mg/L in the failed laparoscopic cases and 9.96 mg/L in the laparoscopic cases.
Conclusion: Patients older than 45 years old with a CT radiologist’s read of a perforation in multivariant analysis have an increased risk of failed laparoscopic surgery requiring conversion to open surgery.
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KEYWORD
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Appendicitis, Laparoscopic appendectomy, Failed laparoscopic, Open appendectomy, Perforated appendicitis
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