Impact of peritoneal lavage on intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis: a propensity score matching analysis

Abstract Objective To investigate the impact of peritoneal lavage on the incidence of intra-abdominal abscess (IAA) after laparoscopic appendectomy (LA) in adults with perforated appendicitis. Methods Clinical data from adult patients intraoperatively diagnosed with perforated appendicitis and undergoing LA at the Affiliated Hospital of Qingdao University between January 2020 and January 2025 were retrospectively analyzed. Patients were divided into a no-peritoneal lavage group and a peritoneal lavage group based on whether peritoneal lavage was performed. A total of 128 patients were included, comprising 91 in the no-peritoneal lavage group and 37 in the peritoneal lavage group. Patient demographics were collected, and propensity score matching (PSM) was employed to compare clinical data between groups. Results After PSM, patient demographics showed no significant differences, indicating good balance (P > 0.05). There were no statistically significant differences between the two groups regarding operative time, postoperative antibiotic duration, postoperative length of stay(LOS), or postoperative IAA incidence (P > 0.05). Conclusion Our findings indicate that compared to suction alone, peritoneal lavage did not reduce the incidence of postoperative IAA in adults undergoing LA for acute perforated appendicitis. There is no evidence that patients benefit from lavage. Prospective multicenter randomized controlled trials are warranted.