Readmission and reoperation rates following negative diagnostic laparoscopy for clinically suspected appendicitis: the "normal" appendix should not be removed - a retrospective cohort study

Sørensen Amira Khattar, Anders Bang-Nielsen, Levic-Souzani Katarina, Pommergaard Hans Christian, Jørgensen Anders Beck, Tolstrup Mai-Britt, Rud Bo, Kovacevic Bojan, Bulut Ohran

8 Citations (Scopus)

Abstract

BACKGROUND: In cases with clinically suspected appendicitis, there is controversy regarding the decision to remove a macroscopically normal appearing appendix during laparoscopy when no other intra-abdominal pathology is found. The aim of this study was to examine the rate of appendicitis, along with readmission and reoperation rates following diagnostic laparoscopy of clinically suspected appendicitis in patients where the appendix was not removed.

METHODS: We performed a retrospective cohort analysis of patients who underwent a diagnostic laparoscopy due to clinical suspicion of appendicitis where no other pathology was found and the appendix was not removed. The study period was from 2008 to 2013 and involved patients from two university hospitals in the Copenhagen area.

RESULTS: Of the 271 patients included (81.6% women, median age 27), 56 (20.7 %) were readmitted with right iliac fossa pain after a median time of 10 months (range 1- 84). Twenty-two patients (8.1 %) underwent a new laparoscopic procedure. Appendix was removed in 18 patients, of which only one showed histological signs of inflammation. The median follow-up time was 5.6 years (range 1 - 109 months).

CONCLUSION: There was a low rate of appendicitis after a previous negative diagnostic laparoscopy. Therefore, based on results from the current study, we do not consider that it is necessary to remove a macroscopic normal appendix during laparoscopy for clinically suspected appendicitis. The high readmission rate warrants the need for further investigation or follow-up.

Original languageEnglish
JournalInternational Surgery
Volume64
Pages (from-to)1-4
Number of pages4
ISSN0020-8868
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Appendectomy
  • Appendicitis
  • Laparoscopy
  • Humans
  • Middle Aged
  • Laparoscopy/methods
  • Male
  • Reoperation/statistics & numerical data
  • Young Adult
  • Appendicitis/surgery
  • Adolescent
  • Aged, 80 and over
  • Appendectomy/methods
  • Adult
  • Female
  • Aged
  • Retrospective Studies
  • Patient Readmission/statistics & numerical data
  • Child

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