Advantages of Interval Laparoscopic Appendectomy for Periappendiceal Abscess

Abstract

Purpose: Laparoscopic appendectomy is a common procedure for treatm ent of appendicitis. H owever , in som e com plicated cases, like periappendiceal abscess, deciding on treatm ent options is very challenging. Early appendectom y or interval appendectomy may be possible, but remains controversial. Met hods: W e prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic m ethod versus 14 patients w ith im medi ate initial laparotom y. Resul ts: In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic m ethod w as advantageous in terms of operation time ( p＜0.001), less fasting tim e (p＜0.001), and fewer postoperative complications (p= 0.032). H owever, the total cost in the INT group w as 1,686,000±940,00 0 South Korean won (KRW) compared with 1,506,000±322,00 0 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required tw o hospital visits. The total length of hospital stay postoperatively, was 7.31±2.726 days in the INT group, compared with 9.21±3.378 days in the EAR group ( p=0.537). Concl u sio n: We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in m ore favorable postoperative surgical outcomes , fewer complications , and less antibiotic usage.