Reducing the negative appendectomy rate with the laparoscopic appendicitis score; a multicenter prospective cohort and validation study.

Background: Approximately nine percent of all acute appendectomies are unintentionally performed on a normal appendix. Failure of treatment (negative appendectomy or missed appendicitis) is associated with higher morbidity and mortality when compared to appendectomy for uncomplicated appendicitis. The Laparoscopic APPendicitis (LAPP) score was developed in order to systematically evaluate the appendix for the presence of inflammation.

[Laparoscopic evaluation of the appendix].

In the Netherlands every year about 16,000 appendectomies are carried out. Despite the increase in preoperative radiological evaluation of the appendix, the negative appendectomy rate is still around 16%, with a morbidity of approximately 5%. The Dutch practice guideline on appendicitis states that a normal appendix should not be removed, although laparoscopic criteria to establish appendicitis are lacking.

Evaluation of the appendix during diagnostic laparoscopy, the laparoscopic appendicitis score: a pilot study.

Background: Diagnostic laparoscopy is the ultimate diagnostic tool to evaluate the appendix. Still, according to the literature, this strategy results in a negative appendectomy rate of approximately 12-18 % and associated morbidity. Laparoscopic criteria for determining appendicitis are lacking.