Diffuse Appendicular Peritonitis: Laparoscopic vs Open Access — Viewpoint From Aside

The perforative acute appendicitis with the development of diffuse peritonitis increases incidence postoperative complications to 47%, and mortality 3%. Mortality in case purulent makes 4.5-58%, it can exceed 70% severe forms infectious-toxic shock multiple organ failure. National Clinical Guidelines for allow appendectomy from both median laparoscopic access absence general contraindications creation pneumoperitoneum. However, despite proven advantages appendectomy, there are opponents its use appendicular peritonitis. An increased number abscesses a minimally invasive approach has been reported literature; however, recent randomized studies refute this fact. There is also evidence that method often leads lengthening operation time higher operating costs, but at same decrease pain syndrome, reduction length inpatient treatment early social labor rehabilitation, which an overall hospital costs. Thus, date, no generally accepted opinion about advisability At moment, presence most common intraoperative reason refusing surgical treatment. tendency trying standardize indications contraindications, was objective our literature review.