Four decades of laparoscopic appendectomy. does it have the same role in the management algorithm of a postappendectomy abscess?

Osman, Tarek A.; Fouad, Ramy H.; Guirguis, Nader N.; Shoka, Ahmed A.

doi:10.4103/ejs.ejs_204_23

Four decades of laparoscopic appendectomy. does it have the same role in the management algorithm of a postappendectomy abscess?

Authors

Abstract

Background/Objective
Postappendectomy abscess (PAA) is the most controversial complication after appendectomy. We aimed to identify the actual incidence of PAA and to compare the success rate of different lines of treatment both in adult and pediatric age groups in our institute.
Methods
A prospective study was conducted on patients who had a radiologically confirmed PAA. They were subdivided into adults (group A) and children (group B). A stepwise approach was used for the management of the PAA. The success rate of each line of treatment was recorded and compared between both groups.
Results
Five hundred twenty appendectomy patients were included in this study (321 adult and 199 pediatric patients). In group A, 14 (4.36%) patients had a PAA in comparison to 9 (4.52%) children in group B. In group A, the success rate of both the medical and surgical treatment was 66.7%, whereas the radiological drainage was successful in the three cases. In group B, medical treatment was successful in 83.3% and the patient who failed medical treatment was drained laparoscopically. The remaining three cases were radiologically drained.
Conclusion
This is the first trial to compare the success rate of different lines of treatment of PAA between adult and pediatric patients. Our results conclude that there is no statistically significant difference between the success rate of each line of treatment.

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