The laparoscopic appendectomy: Indications and results in the General Surgery Department of the Aristide le Dantec Teaching Hospital

Introduction. Acute appendicitis is the most common abdominal surgical emergencies. Appendicectomy may be realized by laparotomy or laparoscopy. Laparoscopy has many advantages in the diagnosis, therapeutics and cosmetics. The aim of our study was to evaluate the indications and the results of laparoscopic appendicectomy in our service. Patients and Methods. It was a retrospective study in General Surgery Department of the Aristide Le Dantec Teaching Hospital in Dakar over a period of 8 years. There were 31 men and 19 women. The average age was 19.4 years. Were included all patients who were treated by laparoscopic appendectomy whatsoever the evolutionary stage of the appendicitis. Seven patients files were excluded because incomplete information. The parameters studied were the epidemiological data, surgical indications, operative and postoperative follow-up data. Results. Our study included 50 patients and represented 39.4% of the laparoscopic surgery activity in our service. Specific abdominal pain was 88%. Leukocytosis was found in 90%. The abdominopelvic ultrasound performed in 20% of cases (10 cases) was contributory to the diagnosis in 80%. In 22% of cases, the diagnosis of acute appendicitis was clinical and laboratory. Laparoscopy was a therapeutic means in 98% of procedures. The number of trocars used was 3 in 36 patients (72%). In exploration, appendix was retro-cecal in 50% and gangrenous in 54% of cases. The intraoperative diagnosis was appendical peritonitis in 58%. All appendectomy performed were "in". The overall conversion rate was 10%. The mean operating time was 68 minutes in case of laparoscopy alone. The sensitivity of laparoscopic diagnosis was 100%. The average time to recovery intestinal transit was 1.7 day. Morbidity rate was 6%. No mortality were recorded. Conclusion. Laparoscopy is an excellent approach for appendectomy and it is performed for diagnosis and treatment. It is the best indication in young women.