Effective laparoscopic drainage for intra-abdominal abscess not amenable to percutaneous approach: report of two cases.

PURPOSE: The usefulness of the laparoscopic approach for massive intra-abdominal abscesses is controversial. We report two patients who underwent laparoscopic abscess drainage for massive intra-abdominal abscesses not amenable to the percutaneous approach that were suspected to be caused by acute appendicitis.

METHODS: In both patients, four ports were placed at their abdominal walls under general anesthesia. Intra-abdominal abscess cavities were punched out, and the purulent exudates that spilled out from the cavities were aspirated completely. Copious irrigation was performed under direct vision. These procedures were completed laparoscopically.

RESULTS: The postoperative clinical courses of the patients were uneventful. The intra-abdominal abscesses did not recur, and no wound complications were recognized. The patients were discharged from our hospital in excellent condition within two weeks.

CONCLUSIONS: Laparoscopic drainage for massive intra-abdominal abscess is a minimally invasive and useful procedure compared with the open method or the percutaneous approach. It offers the advantage of being able to explore of the abdominal cavity without an unnecessary wide incision, and aspiration of a purulent exudate is possible under direct vision.