AB165. 67. Negative appendectomy rates in Beaumont Hospital

Background: The current standard treatment for acute appendicitis is operative intervention with laparoscopic +/− open appendectomy. There is increased pressure to provide beds, resources and theatre space for these patients. The avoidance of surgery in these patients could potentially decrease emergency theatre caseload significantly. Furthermore, the avoidance of surgery in these patients has cost-saving advantages. In Beaumont Hospital, the cost of an appendectomy is €4,060 euro for the average 2.9 day stay, with no post-operative complications.

Methods: HIPE databases were queried to identify all emergency patients with acute appendicitis admitted between January 2013 and December 2015, inclusive. Included were patient demographics, type of radiological scan performed prior to surgery, and histopathological analysis of appendix.

Results: A total of 878 patients were identified with a diagnosis of acute appendicitis. So far, 67 of 298 patients were found to have a normal appendix on histopathology. This equates to a 22.48% negative appendectomy rate. Of these 67 patients, only 3 underwent radiological investigation with either US or CT prior to surgery.

Conclusions: Negative appendectomy rate is 22.48%. In an era of laparoscopic appendectomy, it is unclear why this is the case.

Keywords: Appendicectomy; negative; laparoscopy; rate; factors