Irrigation during laparoscopic appendectomy for complicated appendicitis: time to review current guidelines

It could be asserted that the advent of evidencebased medicine and minimally invasive approaches are among the most remarkable revolutions that general surgeons had to face with during the second half of the 20th century. Still being one of the most common diseases leading to emergency surgery procedures, with a lifetime risk of 8.6% for males and 6.7% for females [1], acute appendicitis (AA) seems to be a paradigm of the challenging changes of current surgical practice. A recent meta-analysis [2] could not demonstrate the superiority of laparoscopic appendectomy (LA) compared with open appendectomy for what concerns the incidence of intra-abdominal abscess (IAA) (odds ratio (OR) 0.79; 95% confidence interval (CI) 0.45–1.37).