Results of laparoscopic appendectomy for perforated appendicitis

Background: Perforated appendicitis is associated with increased risk of po stoperative infectious complications. The role of laparoscopic appendectomy (LA) for perforated appendicitis is controversial. Methods: A retrospectiv e study of all patients with perforated appendicitis treated with either la paroscopic or open appendectomy (OA). Results: Two hundred and thirty-one p atients were diagnosed to have perforated appendicitis in a 7 year period. Eightly-five patients underwent laparoscopy in which 45 patients had laparo scopic appendectomy and 40 patients (47%) required conversion to open proce dure. Open appendectomy was performed in 146 patients. Operative time was s ignificant longer in converted groups (p<0.05) compared to patients with LA and OA (81 min. vs. 66 and 71 min. respectively). Return of diet and disch arge from hospital was faster in LA than OA by 2 days and 1 day respectivel y (p<0.01). Wound infection rate was 9% for LA, compared to 24% for OA or c onverted group (p<0.05). Surgeon's experience of laparoscopic appendectomy was associated with conversion to open procedure. Conclusions: LA is associ ated with high conversion rate to open procedure in perforated appendicitis . However, if LA performed successfully, it offered patients faster recover y and less risk of wound infection.