Should Every Patient Undergoing Laparoscopy for Clinical Diagnosis of Appendicitis Have an Appendicectomy ?

Abstract

In cases of clinically suspected acute appendicitis, the rate of negative laparoscopic exploration ranges from 8 to 15%. In that situation, should we remove an apparently normal appendix or should we leave it in place? If there is no evidence of another cause to explain the acute right iliac fossa pain, it seems reasonable to proceed with an appen-dicectomy even if the appendix looks normal, because the rate of re-operation for recurrent symptoms is up to 6% and an endo-appendicitis which is defined as inflammation of the appendicular mucosa can be present in 11% to 26% of the cases. Anyway, the therapeutic decision is also influenced by the discussion between the physician and the patient before operation as well as by his past medical history. Good information about the risks and advantages of removal and non-removal of an apparently normal appendix must be given.

Key Words:

• Appendicitis
• appendicectomy
• laparoscopy.

Additional information

Notes on contributors

B. Navez

B. Navez Service de Chirurgie Generale et Digestive Hopital St Joseph 6 rue de la Duchere B–6060 Gilly, Belgium