Early Laparoscopic Washout may Resolve Persistent Intra-abdominal Infection Post-appendicectomy

Background Intra-abdominal abscess (IAA) complicates 2–3% of patients having an appendicectomy. The usual management is prolonged antibiotics and drainage of the IAA. From 2006, our unit chose to use early re-laparoscopy and washout in patients with persistent sepsis following appendicectomy. The ai...

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Bibliographic Details
Published in:World journal of surgery 2019-04, Vol.43 (4), p.998-1006
Main Authors: Allaway, Matthew G. R., Clement, Kristenne, Eslick, Guy D., Cox, Michael R.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Abscess - etiology
Abdominal Abscess - therapy
Abdominal Surgery
Adult
Antibiotics
Appendectomy - adverse effects
Appendicitis - surgery
Cardiac Surgery
Demographics
Demography
Drainage - methods
Female
General Surgery
Humans
Intra-abdominal infection
Intraabdominal Infections - etiology
Intraabdominal Infections - therapy
Laparoscopy
Length of Stay
Male
Medicine
Medicine & Public Health
Morbidity
Original Scientific Report
Patients
Postoperative Complications - therapy
Retrospective Studies
Sepsis
Surgery
Therapeutic Irrigation
Thoracic Surgery
Vascular Surgery
Wound drainage
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Summary:Background Intra-abdominal abscess (IAA) complicates 2–3% of patients having an appendicectomy. The usual management is prolonged antibiotics and drainage of the IAA. From 2006, our unit chose to use early re-laparoscopy and washout in patients with persistent sepsis following appendicectomy. The aims of this study were to assess the outcomes of early laparoscopic washout in patients with features of persistent intra-abdominal sepsis and compare those with percutaneous drainage and open drainage of post-appendicectomy IAA. Methods A retrospective case note review was performed for all patients having a laparoscopic washout, percutaneous drainage or open drainage following appendicectomy between January 2006 and December 2017. Results During the period, 4901 appendicectomies occurred. Forty-one (0.8%) patients had a laparoscopic washout, 16 (0.3%) had percutaneous drainage, and 6 (0.1%) had an open drainage. The demographics, ASA grade and pathology at initial appendicectomy were similar. The mean time after appendicectomy was significantly shorter for laparoscopic washout (4.1 days vs. 10.1 and 9.0 days, p  = 
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-018-4871-8