Concomitant resection of Meckel diverticulum during laparoscopic appendectomy: Retrospective propensity-matched ACS-NSQIP study and a case report.

BACKGROUND

The surgical management of incidentally detected Meckel diverticulum (MD) during appendectomy remains controversial. We present a case report alongside an analysis of the ACS-NSQIP database to evaluate postoperative outcomes associated with concomitant Meckel diverticulectomy during laparoscopic appendectomy.

CASE SUMMARY: We report the case of a 34 year-old woman presenting with acute appendicitis and an incidentally detected MD. The patient presented to the emergency department with right lower quadrant pain. Computed tomography revealed acute appendicitis with possible contained perforation. During laparoscopic operative management of her appendicitis, an incidental MD was noted and resected via a stapled diverticulectomy. She was discharged on the same day as her surgery without complication. Postoperative pathology examination revealed an MD without acute pathology. To review outcomes associated with performing incidental Meckel diverticulectomy during laparoscopic appendectomy, an additional 12-year retrospective ACS-NSQIP analysis was performed. To compare between laparoscopic appendectomy alone and Meckel diverticulectomy with appendectomy (MA), propensity matching was employed. MA was associated with a significantly increased operative time and longer hospital stays. However, no significant differences in 30-day mortality or postoperative outcomes were observed between the groups.

CONCLUSION

Resection of incidental MD can be performed during laparoscopic appendectomy without significant morbidity or mortality.