DIAGNOSTIC LAPAROSCOPY IN 1043 PATIENTS WITH SUSPECTED ACUTE APPENDICITIS

Objective: To evaluate the efficacy of diagnostic laparoscopy in patie nts with suspected acute appendicitis, the number of complications ass ociated with the laparoscopic technique, and the effect of leaving a m acroscopically normal-looking appendix in place. Design: Three prospec tive protocols. Setting: Three departments of surgery, one in Norway a nd two in Sweden. Subjects: 1043 patients aged 15 years or over. Inter ventions: Diagnostic laparoscopy in patients with signs and symptoms o f acute appendicitis who were to be operated on. Main outcome measures : Morbidity, mortality, and histological appearance of removed appendi ces, and outcome whether or not the patient was operated on. Results: 819 patients had appendicectomies (61% laparoscopically and 39% by con vertion to open operation) with a total complication rate of 10%. In 2 11 patients a diagnostic laparoscopy was done as a single procedure. T here were 181 women in this group and 86 of them had gynaecological di sorders. The complication rate was 2% among these 211 patients and aft er a follow up of two years no patients had been readmitted for append icectomy. 13 patients were subjected to other open procedures. The ove rall mortality was 0.4%. Conclusion:: Diagnostic laparoscopy is safe a nd can be recommended in patients with suspected acute appendicitis, p articularly in women. a macroscopically normal-looking appendix can be left in place.