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Acute appendicitis after liver transplantation: A single center experience and review of the literature
Ann Hepatobiliary Pancreat Surg 2020 Feb;24(1):44-51
Published online February 29, 2020;  https://doi.org/10.14701/ahbps.2020.24.1.44
Copyright © 2020 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Indah Jamtani*, Sara Kim*, Jeong-Moo Lee, Kwang-Woong Lee, Suk Kyun Hong, Kwangpyo Hong, Eui Soo Han, Nam-Joon Yi, and Kyung-Suk Suh

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
Received October 15, 2019; Revised November 14, 2019; Accepted November 14, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Acute appendicitis is one of the most common emergent disease in the general population requiring surgical treatment. However, only a few cases of appendicitis after liver transplantation (LT) were reported. We described experiences of acute appendicitis after LT in single center.
Methods: From March 1988 to July 2019, we reviewed retrospectively all the patients who diagnosed with acute appendicitis after LT at the Seoul National University Hospital. We described and analyzed clinical outcomes of appendectomy after LT.
Results: A total of 12 patients out of 2,237 LT patients underwent appendectomy due to acute appendicitis. The mean age was 48±12 years. Nine patients (75%) underwent deceased donor liver transplantation (DDLT) and three patients (25%) underwent living donor liver transplantation (LDLT). The mean days from transplantation to the onset of acute appendicitis was 739 (range 57-4,496) days. Every patients underwent appropriate appendectomy within 1 days after visiting hospital. Leukocytosis was seen in three patients (25%). Seven patients (58%) underwent laparoscopic appendectomy and five patients (42%) underwent open appendectomy. The total operative time was 47.5 (range 25–135) minutes. The median postoperative hospitalization was 4 (range 2-11) days. There was no postoperative complications documented. There was no significant difference of clinical outcomes between laparoscopic appendectomy group and open appendectomy group.
Conclusions: Early surgical management achieved satisfactory postoperative results without graft dysfunction after LT. Laparoscopic appendectomy also could be applicable with safe and feasible outcomes even in post-LT recipients.
Keywords : Acute appendicitis; Liver transplantation; Laparoscopy; Appendectomy