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World J Gastroenterol. Oct 21, 2014; 20(39): 14338-14347
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14338
Laparoscopic treatment of perforated appendicitis
Heng-Fu Lin, Hong-Shiee Lai, I-Rue Lai
Heng-Fu Lin, Department of Surgery, Far-Eastern Memorial Hospital, Taipei 220, Taiwan
Heng-Fu Lin, Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
Hong-Shiee Lai, I-Rue Lai, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
I-Rue Lai, Department of Anatomy and Cell Biology, Medical College, National Taiwan University, Taipei 100, Taiwan
Author contributions: All the authors contributed to this manuscript.
Correspondence to: I-Rue Lai, MD, PhD, Department of Surgery, National Taiwan University Hospital, No 7, Chung-Shan South Rd, Taipei 100, Taiwan. iruelai@gmail.com
Telephone: +886-2-23123456 Fax: +886-2-23915292
Received: November 15, 2013
Revised: December 18, 2013
Accepted: May 29, 2014
Published online: October 21, 2014
Abstract

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis.

Keywords: Perforation, Laparoscopic appendectomy, Intra-abdominal abscess, Cost

Core tip: Appendicitis is the most common abdominal emergency, and the perforated appendicitis often leads to serious infectious complication. There are concerns of using laparoscopic appendectomy to perforated appendicitis This article reviewed the recent progress and concerns in using laparoscopic appendectomy for treating perforated appendicitis.