Laparoscopic versus open appendectomy for perforated appendicitis

The role of laparoscopic appendectomy (LA) for perforated appendicitis is under investigation. A retrospective study was conducted to compare the outcomes of laparoscopic versus open appendectomy (OA) for perforated appendicitis. From January 2001 through December 2003, 229 patients with perforated appendicitis were treated at Far-Eastern Memorial Hospital. LA was successfully completed in 91 of 99 patients. OA was performed in 130 patients. Operation time was longer in the LA group (mean +/- SD 96.1 +/- 43.1 vs. 67.8 +/- 32.2 minutes, P < 0.01). Return of oral intake was faster in the LA group (3.2 +/- 2.4 vs. 5.0 +/- 7.0 days, P < 0.01). The intravenous antibiotic usage period was shorter in the LA group (4.4 +/- 2.8 vs. 6.3 +/- 7.1 days, P < 0.01). The postoperative wound infection rates were 15.2 % (LA group) and 30.7% (OA group). The overall infectious complication rates were 19% in the LA group and 37% in the OA group (P < 0.01). Hospital stay days were shorter for the LA group (6.3 +/- 2.9 vs. 9.3 +/- 8.6 days, P < 0.01). Our results indicated that laparoscopic appendectomy is a safe and effective procedure for treating patients with perforated appendicitis.