Laparoscopic approach for acute appendicular peritonitis: Efficacy and safety: A report of 96 consecutive cases

Several authors have demonstrated the feasibility and efficacy of the lapar oscopic approach in the acute abdomen. The aim of this study was to evaluat e the diagnostic performance and safety of laparoscopy as a routine approac h in the management of appendicular peritonitis. This retrospective study i ncluded 96 consecutive cases of acute appendicular peritonitis. All patient s underwent a laparoscopic approach. The mean APACHE II score and Mannheim Peritonitis Index were 7.6 and 17.4, respectively. Laparoscopic diagnostic accuracy was 98%. Laparoscopy allowed the physician to correct the preopera tive suspected diagnosis in 6 patients (6.5%). The results of preoperative clinical evaluation of the peritonitis severity were corrected by laparosco pic exploration in 26% (25/96) of cases. Complete laparoscopic management w as achieved in 79% (76/96). Overall, the postoperative morbidity rate was 1 3% (13/96). Postoperative intra-abdominal abscess and wound sepsis. rates i n patients treated by laparoscopy were 2% and 1%, respectively. There were no deaths. The laparoscopic approach for the management of appendicular per itonitis is safe and effective and does not result in any specific complica tion. Advantages include the high quality of laparoscopic exploration, a ve ry low incidence of septic complications, and a comfortable postoperative r ecovery.