Laparoscopic drainage of pelvic abscess: evaluation of outcome

Abstract

Objective The aim of this study was to evaluate the outcome of laparoscopic drainage (LD) of pelvic and paracolic abscesses not amenable to percutaneous or transrectal computed tomography-guided or ultrasound-guided drainage. Patients and methods Forty patients presented with a picture of acute abdomen. Radiological diagnosis defined 32 primary intra-abdominal abscesses and eight postoperative (PO) abscesses. After laparoscopic exploration, the abscess cavity was entered, and septa were cut down, drained, and irrigated using normal saline. The source of infection was managed if possible and then drains were inserted. Results Thirty-six patients underwent successful LD within a mean operative time of 94.3 min. Four patients required conversion to laparotomy for a conversion rate of 10%. Pain scores showed a gradual significant decrease. The mean duration of peritoneal drainage was 3.7±0.9 days and the mean PO hospital stay was 5.6±1.7 days. Three (8.3%) patients developed PO infection; two patients had a surgical wound infection at the umbilical port site and one patient developed recollection that required second-look LD of pelvic recollection. Two patients were died because of flare-up of an already present medical problem. Conclusion LD was a feasible, safe, and effective minimally invasive procedure for primary or secondary pelvic abscesses, with a conversion rate of 10%. No surgery-related mortality was encountered.