급성 충수염이 의심되는 환자에서 복강경적 수술의 의의

Abstract

Background/Aims: The role of laparoscopy in the treatment of appendicitis has evolved gradually. This study is to identify the significance of laparascopic surgery in the diagnosis and treatment of suspected appendicitis. Methods: From February 1993 to June 1995, we retrospectively reviewed 114 clinical cases of laparoscopic surgery in suspected appendicitis. Twelve cases were proven to have unsuspected findings. This study includes the false positive ratio, distribution of sex and age, operative findings, methods of operation, and postoperative course. Results: The false pasitive ratio is 10.5%. Pelvic inflammatory disease is most the common(4 cases) of the operative findings in false positive cases. The other cases are cecal diverticulitis, acute choleeystitis, omental torsion, bleeding hepatoma, spontaneous bacterial petitonitis, benign ovarian tumor, and vitelline duct remnant. There was no convasion to open laparotomy. All cases with unsuspected findings during laparoscopic appendectomy could have been dane by laparoscopic surgery. There was no surgically related mortality. In complications, there were two cases of seroma on the port site and one case of post-operative bleeding. Conclusions: We conclude that the laparoseopic approach in the operation of suspected appendicitis, especially in women of childbearing age, can be useful in the detection of lesians and is regarded as an effective method in diagnosis and treatment. (Korean J Gastroenterol 1997; 29: 482-488)