Post-Operative Outcomes of Laparoscopic Appendectomy in Acute Complicated Appendicitis: A Single Center Study

Anurag Surabhi; Aparna Behura; Chinmay R Behera; Rajat K Patra; Bandita Panda; Amaresh Mishra; Ranjit Karnati; Subrat Mohanty

doi:10.7759/cureus.38868

Post-Operative Outcomes of Laparoscopic Appendectomy in Acute Complicated Appendicitis: A Single Center Study

Cureus. 2023 May 11;15(5):e38868. doi: 10.7759/cureus.38868. eCollection 2023 May.

Authors

Anurag Surabhi¹, Aparna Behura², Chinmay R Behera¹, Rajat K Patra³, Bandita Panda⁴, Amaresh Mishra¹, Ranjit Karnati¹, Subrat Mohanty⁵

Affiliations

¹ Department of Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
² Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
³ Department of Surgery, Kalinga Institute of Medical sciences, Bhubaneswar, IND.
⁴ Department of Research and Development, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
⁵ Department of Surgery (Pediatric Surgery), Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

Abstract

Background: Acute appendicitis (AA) is a surgical emergency because of inflammation in the appendix leading to swelling, whereas acute complicated appendicitis is characterized by a gangrenous or perforated appendix with or without periappendicular abscess, peritonitis, and an appendicular mass. The laparoscopic approach in complicated acute appendicitis is a viable alternative method but is not practiced in all cases because of technical difficulties and unpredictable complications. Thus, the present study aimed to evaluate the primary and secondary outcome predictors of laparoscopic appendectomy in complicated appendicitis.

Methods: A single-center prospective observational study was carried out after the approval of the Institutional Ethics Committee (IEC). A total of 87 complicated acute appendicitis patients were included in the study. Clinico-demographic features such as age, gender, duration of surgery, post-operative pain, and hospital stay were monitored in different age groups of <20, 20-39, and >40 years, and the primary and secondary outcomes of laparoscopic surgery in acute complicated appendicitis were measured.

Result: Acute complicated appendicitis cases were observed mostly in people older than 42 years in the total study population. Laparoscopic appendectomy was conducted in all 87 acute complicated appendicitis patients, and the major surgical outcome predictors were monitored, such as mean operating time (87.9 minutes), post-operative pain (3.9 scores), and post-operative stay (6.7 days). Post-operative complications such as drain site infection (1.14%), enterocutaneous fistula (2%), and intra-abdominal abscess (7%) were observed.

Conclusion: Based on our observations, a laparoscopic appendectomy can be considered a viable alternative with an acceptable complication rate. Operative time varies from 84 to 94 minutes in different age groups and with the extent of the disease.

Keywords: acute complicated appendicitis; appendicitis; intra abdominal abscess; laparoscopic appendectomy; post-operative outcome.