A simple scoring system to reduce intraabdominal septic complications after laparoscopic appendectomy

Background: The development of intraabdominal abscess (IAA) following lapar oscopic appendectomy (LA) is associated with significant morbidity. The aim of the present study was to validate an IAA risk score constructed from a previous review of 156 consecutive LA, Methods: The score was tested in 250 subsequent consecutive LA and in patie nts with a positive risk score. Broad-spectrum antibiotics were administere d in order to avoid IAA. Results: Factors related to IAA included clinically complicated appendiciti s, leucocytosis >15,000/mul, a difference of >1 degreesC between axillary a nd rectal temperature, intraoperative findings such as (gangrenes and perfo ration), and intraoperative perforation of the appendix. In this series, br oad-spectrum antibiotic therapy in patients with a positive IAA risk score reduced the incidence of IAA from 7.05% to 1.60%. Conclusion: This policy of identifying high-risk patient via the scoring sy stem and instituting subsequent antibiotic therapy in patients at risk redu ces the incidence of IAA following LA.