Drain vs no drain, in complicated appendicitis

Background: The most common complication after perforated appendicitis is intra abdominal abscess, ranging in incidence from 14 to 18%. Drainage following appendectomy is usually determined by whether the underlying appendicitis is simple or
complicated and largely determined by the surgeons’ belief, based on expertise or personal opinion. we discuss the results of patients of perforated appendicitis, treated with or without a abdominal drain. Patients and methods: A retrospective study of patients diagnosed with perforated appendicitis having surgery was performed. Patients diagnosed with perforated appendicitis treated with a abdominal drain and patients treated without a drain. Both groups were evaluated in terms of complications: intra-abdominal abscess, re-intervention, readmission and duration of hospital stay. Results: 200 patients diagnosed with perforated appendicitis underwent appendectomy. 120 patients were treated without drain and 80 patients with a abdominal drain. Thirty-one (26%) patients from the group without a drain had a re-intervention compared to 9 (11%) in the group with a drain (p = 0.013). Overall complications and readmission were also significantly lower in patients treated with a peritoneal drain. Conclusion: An abdominal drain seems to reduce overall complication rate, re-intervention rate and readmission rate in patients treated with perforated appendicitis.