Laparoscopic appendectomy for complicated acute appendicitis in Tikrit emergency hospital

Abstract

Background: With a prevalence of 1.17 cases per 1000 people and an approximate 7 percent risk over the course of a lifetime, acute appendicitis continues to be one of the most common causes of acute abdominal pain Materials and Methods: During the time period of this observational study, which began on January 1, 2022 and ended on November 30, 2022, 57 patients were admitted to the emergency unit of Tikrit General Hospital with a diagnosis of suspected complicated acute appendicitis. Antibiotics and fluids were given intravenously to the patient before the operation. Pneumo-peritoneum was created using either the Verrus needle or the Hasson open approach while the patient was under general anesthesia and intubated with an endotracheal tube. Additionally, the patient was positioned in the supine position. The appendix could be extracted using either the endo-catch bag or the 10 mm port, depending on which method was used. After performing a peritoneal wash with saline until the wash fluid turned clear, an intra-peritoneal tube drain was left either in an appendicular bed or the pelvis. Results:The study enrolled 57 participants (38 females, 19 males) with a mean age of 26.73±6.5 years, ranging from 17 to 50 years. All patients underwent diagnostic laparoscopy, and intra-operative findings showed that 26 patients (45.61%) had perforated appendicitis, 13 patients (22.81%) had gangrenous appendicitis, 11 patients (19.30%) had appendicular abscess, and 7 patients (12.28%) had appendicular mass. The mean operation time was 49.5±16.86 minutes, with a range of 39 to 117 minutes. Laparoscopy was the preferred option for 52 patients (91.23%), while 5 patients required open surgery. Hospital stay duration varied, with 13 patients staying for 2 days, 20 patients for 3 days, 17 patients for 4 days, and 4 patients for more than 5 days. During the post-operative follow-up, 43 patients had no complications (75.44%), 2 patients (3.51%) had a fever with a collection on follow-up ultrasound, 5 patients (8.77%) had a fever without a collection, 2 patients (3.51%) had postoperative ileus, and 3 patients (5.26%) had wound seroma or infected seroma. Conclusions: This study shows that laparoscopic appendectomy may treat severe appendicitis safely and effectively. It reduced hospital stays and conversions. Prevents postoperative infections.