Background
Acute gangrenous and perforating appendicitis are associated with an increased risk for postoperative complications and have been considered a relative contraindication of laparoscopic appendectomy.
Objective
To determine the complication rate following laparoscopic appendectomy for gangrenous or perforating appendicitis.
Design
A retrospective analysis of patients who underwent laparoscopic appendectomy for gangrenous or perforating appendicitis.
Setting
A multispecialty clinic.
Results
Fifteen patients underwent laparoscopic appendectomy for gangrenous appendicitis and 19 patients for perforating appendicitis. In the gangrenous appendicitis group, average operating time was 85 minutes; average length of hospitalization, 2 days; and morbidity rate, 7% (one patient with abdominal abscess). The perforating appendicitis group had an average operating time of 84 minutes, hospitalization of 7 days, and a morbidity rate of 42%. This morbidity included five patients (26%) who developed intra-abdominal abscesses, two patients (10%) in whom wound infections developed, and one patient (5%) who died of Candida sepsis and multisystem organ failure.
Conclusions
Laparoscopic appendectomy can be safely performed in gangrenous appendicitis. Laparoscopic appendectomy for perforating appendicitis is associated with prolonged hospitalization and an increased risk for infectious complications.
(Arch Surg. 1996;131:509-512)
