A simple scoring system to reduce intraabdominal septic complications after laparoscopic appendectomy

Background: The development of intraabdominal abscess (IAA) following laparoscopic appendectomy (LA) is associated with significant morbidity. The aim of the present study was to validate an IAA risk score constructed from a previous review of 156 consecutive LA. Methods: The score was tested in 250 subsequent consecutive LA and in patients with a positive risk score. Broadspectrum antibiotics were administered in order to avoid IAA. Results: Factors related to IAA included clinically complicated appendicitis, leucocytosis >15,000/ml, a difference of >1°C between axillary and rectal temperature, intraoperative findings such as (gangrenes and perforation), and intraoperative perforation of the appendix. In this series, broad-spectrum antibiotic therapy in patients with a positive IAA risk score reduced the incidence of IAA from 7.05% to 1.60%. Conclusion: This policy of identifying high-risk patient via the scoring system and instituting subsequent antibiotic therapy in patients at risk reduces the incidence of IAA following LA.