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Laparoscopic drainage of pelvic abscess: evaluation of outcome

The Egyptian Journal of Surgery • 2017
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Publication Information
Authors Mostafa Baiuomy, Hussein G. Elgohary, Ehab M. Oraby
Keywords acute appendicitis, diverticulitis, laparoscopic drainage, pelvic abscess
Journal The Egyptian Journal of Surgery
Publisher Wolters Kluwer Health - Medknow
Volume 36
Issue 1
Pages 34-51
publication.type International
Paper Link Open Link
Supplementary Materials Not Available
Abstract
Objective
The aim of this study was to evaluate the outcome of laparoscopic drainage (LD) of
pelvic and paracolic abscesses not amenable to percutaneous or transrectal
computed tomography-guided or ultrasound-guided drainage.
Patients and methods
Forty patients presented with a picture of acute abdomen. Radiological diagnosis
defined 32 primary intra-abdominal abscesses and eight postoperative (PO)
abscesses. After laparoscopic exploration, the abscess cavity was entered, and
septa were cut down, drained, and irrigated using normal saline. The source of
infection was managed if possible and then drains were inserted.
Results
Thirty-six patients underwent successful LD within a mean operative time of
94.3 min. Four patients required conversion to laparotomy for a conversion rate
of 10%. Pain scores showed a gradual significant decrease. The mean duration of
peritoneal drainage was 3.7±0.9 days and the mean PO hospital stay was 5.6±1.7
days. Three (8.3%) patients developed PO infection; two patients had a surgical
wound infection at the umbilical port site and one patient developed recollection that
required second-look LD of pelvic recollection. Two patients were died because of
flare-up of an already present medical problem.
Conclusion
LD was a feasible, safe, and effective minimally invasive procedure for primary or
secondary pelvic abscesses, with a conversion rate of 10%. No surgery-related
mortality was encountered.