• Felipe Quezada, Nicolas Quezada, Ricardo Mejia, Alejandro Brañes, Oslando Padilla, Nicolas Jarufe, and Fernando Pimentel.
• Digestive Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
• Int J Surg. 2015 Jan 1; 13: 80-83.

BackgroundControversial evidence exists regarding the laparoscopic approach in patients with acute appendicitis complicated with peritonitis due to a higher rate of surgical complications. The aim of this study was to compare post-operatory outcomes in patients with acute appendicitis complicated exclusively with peritonitis approached by laparoscopy versus open surgery.MethodsSingle center retrospective analysis of clinical records of patients with appendicitis complicated with peritonitis operated from January 2003 until October 2013. Demographic data, intra-operative variables, length of stay, surgical complications, mortality, readmissions and reoperations were retrieved.Results227 patients were identified, 43% males, mean age 39±17 years (range: 12-85 years). Ninety-seven patients (43%) underwent laparoscopic appendectomy, 13 of them were converted to open surgery (13%). Ninety-four patients presented with diffuse peritonitis (41.4%). Laparoscopic appendectomy showed longer operative time but shorter hospital stay (p<0.05). There were no differences in post-operatory complications (intra-abdominal abscess, surgical site infection and prolonged ileus). Laparoscopic appendectomy was associated with lower odds for developing any surgical complication in the multivariate analysis (OR 0.301, p=0.036).ConclusionBoth approaches showed no differences in complications in the management of appendicitis complicated exclusively with peritonitis. In our experience, laparoscopic appendectomy is a safe approach in cases of appendicitis complicated exclusively with peritonitis.Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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