Value of diagnostic laparoscopy in fertile women with suspected appendicitis

Objective: To assess the value of diagnostic laparoscopy in women of child- bearing age with suspected appendicitis. Design: Prospective, non-randomised study. Setting: University hospital, Sweden. Subjects: 94 women aged between 15 and 40 years with suspected appendicitis . Intervention: Diagnostic laparoscopy. If necessary, the appendix was remove d either laparoscopically or by open operation. The outcomes were compared with those during 1994, during which all appendicectomies were done through a laparotomy. Main outcome measures: Rates of unnecessary appendicectomy, operating time, and length of hospital stay. Results: 77 had diagnostic laparoscopy, and 17 primary open appendicectomy. 73 appendixes were removed; 53 open and 20 laparoscopically. 12 appendicec tomies (13%) were unnecessary compared with 27/80 (34%) during the year 199 4. The duration of the open operation was significantly shorter (mean (SD) 35 (14) minutes) than the laparoscopic one (78 (18) minutes) (p<0.001), and there were no differences in duration of postoperative hospital stay. No p atients developed complications. Conclusions: Diagnostic laparoscopy is safe and helpful in suspected cases of appendicitis and could substantially reduce the rate of unnecessary appe ndicectomies. However, the data suggest that laparoscopic appendicectomy of fers no advantages over primary open appendicectomy in terms of postoperati ve course.