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Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis

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Abstract

Purpose

Evaluation of the feasibility, cost-effectiveness, time of surgery, morbidities, and other/additional findings during laparoscopy for suspected appendicitis.

Methods

Prospective evaluation of 148 laparoscopies for suspected acute appendicitis.

Results

Laparoscopic appendectomy was safe and cost-effective. No appendiceal stump leaks or wound infections occurred. Of the patients, 4.7% developed intra-abdominal abscesses. Mean time of all procedures was 47 min: 42 min for simple appendectomies (n = 126), 67 min for perforated appendicitis (n = 15), and 75 min for converted procedures (n = 7). Twenty-one of 148 (14.2%) patients had unexpected findings instead of appendicitis: inflamed epiploic appendices (three times), inflammatory disorders of intestine (five times), intestinal adhesions (two times), ovarian cysts (six times: one time with mesenteric lymphadenitis, one time ruptured), tubo-ovarian abscess (one time), tubal necrosis (one time), adnexitis with mesenteric lymphadenitis (one time), and acute cholecystitis (one time). These diagnoses might have been missed during conventional open appendectomy and were, if necessary, treated during laparoscopy.

Conclusions

Laparoscopic appendectomy should be recommended as standard procedure for acute appendicitis.

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Authors and Affiliations

  1. Department of Surgery, St. Adolf-Stift Hospital, Reinbek, Germany

    Lars Ivo Partecke, Annette Karrasch & Jürgen Tepel

  2. Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Greifswald, Ernst-Moritz-Arndt-University, Greifswald, Germany

    Lars Ivo Partecke, Wolfram von Bernstorff, Katharina Cziupka, Anne Glitsch, Albrecht Stier & Claus Dieter Heidecke

  3. Department of General, Visceral and Thoracic Surgery, Klinikum Osnabrück, Osnabrueck, Germany

    Jürgen Tepel

  4. Department of General, Visceral, Thoracic and Vascular Surgery, Universitätsklinikum Greifswald, Ernst-Moritz-Arndt-University Greifswald, Friedrich-Loeffler-Str. 23b, 17489, Greifswald, Germany

    Lars Ivo Partecke

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  1. Lars Ivo Partecke
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  2. Wolfram von Bernstorff
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Correspondence to Lars Ivo Partecke.

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Partecke, L.I., von Bernstorff, W., Karrasch, A. et al. Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg 395, 1069–1076 (2010). https://doi.org/10.1007/s00423-009-0567-8

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  • DOI: https://doi.org/10.1007/s00423-009-0567-8

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