Risk Factors for Conversion in Laparoscopic Appendicectomy: A Cross-Sectional Study in a Middle-Income Country

Background: To compare the operative time, intra-operative complications, hospital stay after surgery in patients undergoing appendicectomy with two port laparoscopic assisted appendicectomy versus three port appendicectomy considering all these factors. Patients and Methods: The is a prospective controlled randomized study performed on 50 patients admitted in Department of General Surgery, with diagnosis of acute appendicitis, recurrent appendicitis and those who were kept for interval. All patients with inflamed but non adhesive appendix were taken for study as cases irrespective of age and sex. They were randomly divided into two groups - group A and group B of 25 patients each. Patients with appendicular lump or those cases requiring conversion to open surgery were excluded from the study. Data were compared with cases of two port laparoscopic assisted appendicectomy versus three port appendicectomy. Results: In this study, 50 patients underwent appendicectomy, 16 patients were operated for acute appendicitis, 24 for recurrent appendicitis and on 10 patient's interval appendicectomy were performed. In 2-port laparoscopic assisted appendicectomy group 9 (36%) patients were operated for acute appendicitis, 11 (44%) for recurrent appendicitis and 5 (20%) as interval appendicectomy. In 3-port laparoscopic appendicectomy group 7 (28%) patients were operated for acute appendicitis, 13 (52%) for recurrent appendicitis and 5 (20%) as interval appendicectomy. None of the patients undergoing 2 - port laparoscopic assisted appendicectomy needed conversion to open appendicectomy. The mean duration of surgery was shorter in 2 port laparoscopic assisted appendicectomy 22.4 ± 5.61 minutes as compared to 3-port laparoscopic appendicectomy 43 ± 16.89 minutes ( P value-0.05). Mean length of hospital stay after surgery was 1.28 ± 0.293 days after 2 port laparoscopic assisted appendicectomy and 2.48 ± 0.927 days after 3-port laparoscopic appendicectomy. Conclusion: It is better in terms of operative time, post-operative complications and hospital stay, although there is not much difference between either intra-operative or post-operative complications. Nowadays, laparoscopic surgery/minimally invasive surgery is the best choice and it causes less postoperative pain and early recovery because of minimal trauma to the patients during surgery. In view of cost, conversion to open surgery and cosmetic results, two port laparoscopic appendicectomy is better. Two port can be used as an alternative to the three-port laparoscopic procedure with acute appendicitis and a favourable outcomes.

Background: Acute appendicitis is the most common etiology of acute abdomen, generally requiring urgent surgical intervention, with a lifetime incidence between 7 and 9%. With the experience in minimal invasive surgery, laparoscopy has advantage of being both diagnostic and therapeutic. In developing country like Nepal, with limited health resources, the trend of laparoscopic appendicectomy (LA) is emerging. This study was conducted to determine difference in clinical outcome and cost analysis between laparoscopic (LA) and open appendicectomy (OA).Methods: This study was Randomized Controlled Trial conducted in the Department of Surgery, B.P. Koirala Institute of Health Sciences (BPKIHS), a tertiary care hospital in Eastern Nepal, over a period of twelve months from January 2017 to December 2017. Ethical clearance was obtained from Institutional Review Committee (IRC). The study population were adults with clinical diagnosis of acute appendicitis fulfilling inclusion and exclusion criteria.Results: In this study, 47% patients were male and 53% were female in LA and 58.8% patients were male and 41.2% were female in OA ; the mean age was 24.6 years in LA and 27.7 years in OA ; mean operation time was more in LA than in OA i.e. 70 minutes and 57 minutes respectively (p value 0.001); mean hospital stay was more for OA (3.6 days) as compared to LA (3.06 days), (p value 0.125) ; The number of analgesic injections during postoperative period in two groups was 5.52±0.99 for LA, 5.62±1.02 for OA (p value 0.626); infection rate was 1% in LA, 6% in OA; The cost of surgery was higher in case of LA (NRs 15067.04) than in OA (NRs. 12524).Conclusions: OA had statistically significant lower pain in 1st three postoperative periods, and a shorter hospital stay, early postoperative recovery but a slightly higher cost per discharge than OA.

To compare open appendectomy (OA) with laparoscopic appendectomy (LA) for length of the operation, complications, postoperative pain control, length of hospitalization, postdischarge recovery time, and hospital charges. Prospective randomized clinical trial of patients with acute appendicitis. Tertiary care, urban teaching hospital. A population-based sample of patients (aged > or = 12 years; weight, > 49.7 kg) admitted to a surgical teaching service with a clinical diagnosis of acute appendicitis. Patients were prospectively randomized to either OA or LA during a 20-month period (from April 1, 1994, to December 31, 1995). Fifty-seven patients were initially enrolled in the study; 7 did not complete the study because of a protocol violation. All remaining patients completed the study, including postdischarge follow-up. Two (7.4%) of the 27 patients in the LA group required conversion to OA because of technical difficulties. One patient (in the OA group) underwent a second surgical procedure for drainage of a pelvic abscess. Three patients (in the LA group) required second surgical procedures. For analysis, no crossovers were allowed and all patients remained in their originally randomized group. Length of the operation, intraoperative and postoperative complications, postoperative pain control, length of hospitalization, postdischarge recovery time, and hospital charges. Fifty patients (19 women and 31 men) were examined. Twenty-seven patients underwent LA, 2 requiring conversion to an OA. Twenty-three patients underwent an OA. Patient demographics were similar between groups. Statistical differences between the 2 groups were found for (1) length of the operation (median, 81.7 vs 66.8 minutes, LA vs OA groups: P < .002), (2) operating room charges (median, $3191 vs $1514, LA vs OA group; P < .001), and (3) total hospital charges (median, $5430 vs $3673, LA vs OA group; P < .001). No statistical differences between the 2 groups were found for (1) length of hospitalization (median, 1.1 vs 1.2 days, LA vs OA group), (2) pain control (mean, 4 vs 3.7 of 10 [0 indicates least pain; 10, most pain], LA vs OA group), (3) recovery time (time necessary before returning to work or school) (median, 14.0 days for both groups), and (4) complications (5 vs 1, LA vs OA group). Laparoscopic appendectomies and OAs are comparable for complications, postoperative pain control, length of hospitalization, and recovery time. Patients who underwent an OA had a shorter operative time and lower operating room and hospital charges. Laparoscopic appendectomy does not offer any proved benefits compared with the open approach for the routine patient with acute appendicitis.

See Article on Page 105-110 Acute appendicitis is the one of the most common conditions requiring surgical intervention, and an appendiceal abscess or phlegmon has an incidence rate of about 3.8% among patients with a perforated appendicitis [1]. An immediate appendectomy for the treatment of a periappendiceal abscess (PAA) or phlegmon is technically demanding with adhesive loops of the bowel and a distorted anatomy, and the appendiceal stump is difficult to close due to the presence inflamed tissues [2]. In actual practice, not infrequently, even an early laparoscopic surgery will be converted to a more extensive open surgical procedure, such as an ileocecal resection or a right hemicolectomy, due to technical problems or distorted anatomy [3]. In the management of perforated appendicitis with a well-defined abscess and an inflammatory phlegmon seen on an image study, an alternative treatment may be nonsurgical management, including intravenous antibiotics and selective percutaneous drainage. Currently, a treatment widely accepted among surgeons is initial nonoperative management followed by an interval appendectomy rather than an immediate appendectomy, but the management of the appendiceal mass remains a matter of major controversy in current practice. However, many surgeon still agree that an interval appendectomy is to be preferred because the risk for recurrent acute appendicitis is reported to be about 10% and because a definite diagnosis needs to be established to rule out any underlying malignancy [4,5]. The advantage of the interval appendectomy is that the operation is performed at a time when peritoneal contamination has been resolved, potentially resulting in fewer intraoperative and/or postoperative complications. Although this advantage has led to the widespread application of drainage/interval appendectomy, published data describing how these patients fare during the interval between percutaneous abscess drainage and minimally invasive surgery are rare. The superiority of an early laparoscopic appendectomy (LA) over an interval LA has been shown in some reports on patients with a well-formed abscess [6,7]. This pilot randomized trial found no major differences in outcomes when comparing an early LA with an interval LA [6]. In another randomized study on appendiceal phlegmon, Blakely et al. [7] concluded that, compared to an interval LA, an early LA significantly reduced the time away from normal activities and the rates of overall adverse events and had a conversion rate comparable to that of an open appendectomy. Schurman et al. [8] also reported that their patients managed with an interval LA were likely to suffer a more negative impact on their quality of life than those managed with an immediate LA. Based on these studies, the issue of whether an interval LA is superior to an early LA for the treatment of an appendiceal phlegmon remains a topic of debate. As experience with the single-incision technique grows, the role of immediate surgery in the treatment of patients presenting with an abscess deserves to be reconsidered. Conservative management followed by a single-incision laparoscopic interval appendectomy using a multichannel single port appears feasible and safe for the treatment of patients with acute perforated appendicitis with a PAA, as this study shows [9]. However, this study has several limitations, including its retrospective nature, small number of patients, and lack of data on surgical outcomes such as quality of life and pain or cosmesis for both single-port and multiport surgeries. Therefore, further large-scale comparative studies are needed to prove the advantages of this procedure by comparing the outcomes for initial nonoperative management followed by an interval appendectomy to the outcomes for an early laparoscopic appendectomy in patients with perforated appendicitis and a PAA.

Introduction:Acute appendicitis is the most common surgical emergency with a lifetime incidence of 7%–8%. There are two operative modalities that are currently used for the management of this condition in the paediatric population. The objective of this cohort study was to review the outcome of the management of paediatric surgical patients presenting with acute appendicitis after either an open appendectomy (OA) or laparoscopic appendectomy (LA) was performed.Methods:This was a 2-year retrospective study conducted from 01 January 2016 until 31 December 2017 on paediatric surgical patients < 13 years of age undergoing appendectomies. Eighty-one (n = 81) files of patients were reviewed, and data analysis was performed on two comparative groups namely the OA group and LA group, with the aid of the SAS system with statistical significance based on P < 0.05.Results:During the study period, 81 children (male: female ratio of 2:1) underwent appendectomies. Nearly 38% (n = 31) of the cases had an OA, with 62% (n = 50) of the cases having an LA. Seven (14%) LA cases were converted to OA. Simple appendicitis accounted for 16% (n = 13) of the patients, with complicated appendicitis accounting for 79% (n = 64) and other pathologies accounting for 5% (n = 4). There were no post-operative complications in the cases of simple appendicitis. Six cases (15.38%) in the LA group versus two cases (5.26%) in the OA group developed intra-abdominal collections, which was statistically significant (P = 0.018). One (2.56%) patient in the LA group versus two patients (7.89%) in the OA group developed intestinal ileus (P = 0.09). Two patients (5.13%) in the LA group versus six patients (15.79%) in the OA group developed surgical-site infection, which was statistically significant (P = 0.013). The mean days of hospital stay was 4.51 days in the LA group versus 5.34 days in the OA group, which was statistically significant (P = 0.016). There were no re-admissions or re-operations in the simple appendicitis group. In the complicated appendicitis cases, five cases (12.82%) were re-admitted in the LA group compared to five cases (13.16%) in the OA group (P = 0.943). Two (5.13%) cases had a re-operation in the LA group compared to one case (2.63%) in the OA group (P = 0.360).Conclusion:Considering that there was an increased incidence of complicated cases and operations being performed by trainees, LA appears feasible at a tertiary-level hospital in a developing country, as shown in this study. Therefore, cases of simple appendicitis can be performed laparoscopically; however with regard to complicated appendicitis, there is no superiority between the two operative modalities in this study, which is consistent with international literature. However, in this study, it can be postulated that the learning curve was a major contributory factor to the increased levels of complications, as all operations were performed by trainees. Therefore, we recommend implementation of adequate simulation practices in laparoscopy in the setting of a developing country to attain the laparoscopic expertise of our international counterparts in order to improve the standard of care.

Background: Acute appendicitis in children is the most common surgical emergency. Good outcomes have been reported with laparoscopic appendectomy (LA) in children for uncomplicated appendicitis. But the use of laparoscopy for complicated appendicitis in children is more controversial. Higher incidences of postoperative abdominal and wound infections have been reported. The purpose of this study was to retrospectively compare LA and open appendectomy (OA) for complicated appendicitis in children.Methods: The outcome of 73 patients with complicated appendicitis was retrospectively analyzed. There were 36 children in the LA group and 37 in the OA group. Data collection included demographics, duration of symptoms, type of complicated appendicitis, operative time, resumption of diet, early and late complication, length of hospitalization and duration of antibiotic use.Results: No significant difference was found with respect to age, duration of symptoms and total leucocyte count between two groups. The operative time for LA (55.83±4.81 minutes for LA versus 67.16±4.27 minutes for OA; p=0.0001) was shorter. Patients in the LA group returned to oral intake earlier (2.83±0.31 days for LA versus 3.84±0.33 days for OA; p=0.001) and had a shorter length of hospital stay (5.11±0.55 days for LA versus 7.92±1.06 days for OA; p=0.0001). The incidence of wound infection in group LA was 5.5% compared to 18.9% in OA group.Conclusions: The laparoscopic technique for complicated appendicitis in children is feasible, safe. Laparoscopic appendectomy should be the initial procedure of choice for most cases of complicated appendicitis in children.

Trends in utilization and outcomes of laparoscopic versus open appendectomy

The purpose of this review was to evaluate the incidence of postoperative intraabdominal abscess formation following laparoscopic and open appendectomies. The current study retrospectively examines appendectomies performed during the period from January 1993 to July 1994. Excluded were cases which were started laparoscopically but converted to open procedures. There were 1,287 cases identified; 597 were perforated (46%), 114 were gangrenous (9%), and 576 were acute (45%). These diagnoses represent intraoperative diagnoses. Of the 576 appendectomies for acute appendicitis, 64 (11%) were performed laparoscopically. There were four intraabdominal abscesses (0.7%), all occurring after open procedures. Of the 114 appendectomies for gangrenous appendicitis, 16 (14%) were done laparoscopically. There were two postoperative abscesses (1.8%), one following an open and one following a laparoscopic procedure. There was no significant difference in abscess rate between laparoscopic and open appendectomies for either acute or gangrenous appendicitis. Of the 597 appendectomies for perforated appendicitis, 28 (5%) were done laparoscopically. There were 19 postoperative abscesses in the whole group, accounting for a 3.2% abscess rate. Sixteen abscesses occurred after open appendectomies and three occurred after laparoscopic appendectomies (2.9% vs 11%, P = 0.054). The preoperative diagnosis was incorrectly identified as acute appendicitis in 95 cases subsequently found to have perforated appendicitis; there was only 1 postoperative abscess in this group. There was no difference in postoperative stay in the open vs laparoscopic group (6.3 days vs 6.1 days). We found no significant difference in the rate of postoperative intraabdominal abscess formation between laparoscopic and open appendectomies in cases of acute or gangrenous appendicitis. However, laparoscopic appendectomy for perforated appendicitis was associated with an important trend toward a higher rate of postoperative intraabdominal abscess formation than open appendectomy. This observation calls for closer prospective scrutiny of laparoscopic appendectomy in the setting of perforated appendicitis.

Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. To describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA.

Laparoscopic appendicectomy in obese is associated with improvements in clinical outcome: Systematic review

BackgroundLaparoscopic appendectomy is not yet unanimously considered the “gold standard” in the treatment of acute appendicitis because of its higher operative time, intra-abdominal abscess risk, and costs compared to open appendectomy. This study aimed to compare outcomes and cost of laparoscopic and open appendectomy in a district hospital.MethodsA retrospective analysis of 230 patients who underwent appendectomy at the Division of General Surgery of the Civil Hospital of Ragusa, Italy, from May 2008 to May 2012 was performed. The variables analyzed included patients data (age, gender, previous abdominal surgery, preoperative WBC count, duration of symptoms, ASA risk score), rate of uncomplicated or complicated appendicitis, operative time, postoperative complications, length of hospital stay, and total costs. The patients were divided in two groups according to the surgical approach and compared for each variable. The results were analyzed using the t Student test for quantitative variables, and the Chi-square test with Yates correction and Fisher exact test for categorical.ResultsLaparoscopic appendectomy was performed in 139 patients, open appendectomy in 91. Two cases (1.4%) were converted to open procedure and included in the laparoscopic group data. Patient data and rate of complicated appendicitis were similar in the two study groups. There was no statistical difference (p = 0.476) in the mean operative time between the laparoscopic (52.2 min; range, 20–155) and open appendectomy (49.3 min; range, 20–110) groups. The overall incidence of minor and major complications was significantly lower (p = 0.006) after laparoscopic appendectomy (2.9%, 4 cases) than after open appendectomy (13.2%, 12 cases); rate of intra-abdominal abscess were similar. The length of hospital stay was significantly shorter (p = 0.001) in laparoscopic group (2.75 days; range, 1–8) than in open group (3.87 days; range, 1–19). The mean total cost was 2282 Euro in laparoscopic group and 2337 Euro in open group, with a no significant difference of 55 Euro (p = 0.812).ConclusionLaparoscopic appendectomy is associated with fewer complications, shorter hospital stay, and similar operative time, intra-abdominal abscess rate, and total costs, compared with open appendectomy. Therefore, laparoscopic appendectomy can be recommended as preferred approach in acute appendicitis.

Background: Complicated appendicitis, characterized as perforated, gangrenous, or abscessed appendix is a common surgical emergency with morbidity that is greater than uncomplicated disease. Open appendectomy (OA) has long been the standard of practice but laparoscopic appendectomy (LA) is being increasingly used because of the advantages that it could have on pain management, wound healing and recovery. Its use in the complicated cases is however controversial especially in low- and middle-income countries. Objectives: To make a comparison between the results of laparoscopic and open appendectomy in tertiary care hospitals of Pakistan in patients with complicated appendicitis. Methods: A prospective clinical trial was conducted at the general surgery departments of two tertiary care hospitals in Pakistan, between March 2023 and March 2024. Sixty patients aged 15 to 60 years with intraoperative confirmed complicated appendicitis were randomly grouped into two equal samples; LA (n=30) and OA (n=30). The outcomes measured were: operative time, postoperative pain (VAS), wound infection, intra-abdominal abscess, hospital stay and return to normal activity. The SPSS v26 was used to conduct the statistical analysis with significant value of p &lt; 0.05. Results: The mean time taken during operations was higher in LA (84.6 ± 14.8 minutes) as compared to OA (66.2 ± 12.9 minutes, p&lt;0.001). At 24 and 48 hours, LA experienced less postoperative pain (p&lt;0.001) with 4.1 and 2.8, respectively. The infection rate of the wound was lower in LA (6.7% vs. 20%, p=0.04) whereas the rate of intra-abdominal abscess was equal (10% vs. 6.7%, p=0.64). The patients of LA had reduced hospitalization (3.6 ± 1.1 vs. 5.3 ± 1.4 days, p&lt;0.001) and quicker recovery (9.4 ± 2.5 vs. 14.7 ± 3.3 days, p&lt;0.001). Conclusion: Laparoscopic appendectomy is a better and safer alternative to open appendectomy in complicated appendicitis. Although it has a longer operating period, it provides less pain, less wound infection, less hospitalization and faster functional recovery which makes it more useful in tertiary care Pakistan hospitals.

Background: The most common emergency for surgery in the population is acute appendicitis. Though laparoscopic appendectomy is widely performed today, the advantages of laparoscopic versus open appendectomy remain under contro-versy. Aim of Study: To determine whether Laparoscopic Ap-pendectomy (LA) is better than thetraditional Open Appen-dectomy (OA). Patients and Methods: It is a prospective study, involving 150 patients with acute appendicitis. All patients undertook abdominoal and pelvic ultrasonography, to exclude any con-comitant gynecological finding and other cause for right iliac fossa pain. The patients were admitted to in Al-Zahraa University Hospital and Kobry El-Koba Military Hospital during the period from November 2017 to November 2019. Operational time, post-operative pain, first bowel movement, hospital stay, early work return and post-operative complications were compared in patients with open versus laparoscopic appen-dectomy. Results: OA and LA were performed in 150 patients (75 patients for each procedure). The laparoscopic technique gave less length of hospital stay (p=0.025), better in operative time, short hospital stay, low visual pain analogue range, first bowel motion recorded and early return to normal activity (p < 0.01), less intraoperative and post-operative complications 6.7% of all patients had complications post-operatively all in open group. Conclusion: The advantage of laparoscopic appendectomy is decreased pain following surgery, a short hospitalization, and an early return to work. Laparoscopic appendectomy should be recommended for acute appendicitis as an effective and safe procedure.

Background: Appendectomy is one of the most common surgical emergencies worldwide and is performed using either an open or a laparoscopic approach. Although minimally invasive surgeries are replacing open surgical procedures, laparoscopic appendectomy (LA) has not yet been established as the gold standard procedure compared to open appendectomy (OA). This study aimed to compare the outcomes of LA and OA in 100 cases and evaluate the feasibility, safety, and efficacy of LA as the preferred method for treating acute appendicitis. Methods: This study was a prospective comparative analysis of 100 patients with acute appendicitis who underwent LA or OA. This study was conducted at a tertiary care hospital (CMH Chattogram) between January 2021 and April 2023. Patients were divided into two groups: laparoscopic (n=50) and open (n=50) appendectomy. Both groups were compared for operative time, length of hospital stay, postoperative pain, complication rate, time to return to normal activity, and cosmetic outcome. Results: The mean operative time was significantly longer in the LA group (43 minutes) compared to the OA group (36.4 minutes) (p&lt;0.001). However, the LA group had significantly less postoperative pain with a mean VAS score of 2.04 at 48 hours postoperatively compared to 5.7 in the OA group(p&lt;0.001). LA group had a shorter length of hospital stay compared to the OA group (3.12 days versus 6.48 days, p&lt;0.001) and a faster time to return to normal activities (7.68 days versus 16.58 days, p&lt;0.001). the LA group had less surgical site infection compared to the open group, with 2 out of 50 compared to 8 in the open group (p&lt;0.46). The cosmetic outcome was measured with the scar scale where the LA group had a significantly better-looking scar with a score of 4.28 versus the score of 8.86 (p&lt;0.001) in the case of the OA group. Conclusions: While the longer operative time of LA was a drawback, its benefits in terms of the better visual field of vision during operation and improved patient outcomes make it the more favorable option for appendectomy.

Objective: This study aimed to compare the intraoperative and postoperative outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) in patients diagnosed with acute appendicitis, with a focus on surgical outcomes and recovery parameters. Methods: A retrospective analysis was conducted on 376 patients who underwent appendectomy for acute appendicitis at İzmir City Hospital between October 15, 2023, and August 15, 2024. Patients were grouped based on surgical approach (LA or OA). Data on demographic characteristics, body mass index (BMI), operative duration, intraoperative blood loss, time to oral intake, length of hospital stay, return-to-work time, and postoperative complications were collected and analyzed. Statistical significance was defined as p &lt; 0.05. Results: Of the 376 patients, 251 underwent LA and 125 underwent OA. The mean operative duration was significantly longer in the LA group (102.56 ± 44.4 minutes vs. 85.4 ± 43.11 minutes, p = 0.009). However, intraoperative blood loss was significantly lower in the LA group (29.64 ± 62.97 mL vs. 74.79 ± 168.55 mL, p = 0.018). Postoperative pain scores (VAS) were significantly lower in LA patients, and they experienced a shorter hospital stay and faster return to work (p &lt; 0.001). The incidence of wound infections was lower in the LA group compared to the OA group (5% vs. 12%, p = 0.03). Conversion from LA to OA occurred in 2.9% of cases due to intraoperative complications such as bleeding, perforation, or inadequate visualization. Conclusion: Laparoscopic appendectomy demonstrated favorable postoperative outcomes compared to open appendectomy, including reduced postoperative pain, shorter hospital stays, and quicker recovery. These results support the adoption of LA as a safe and effective alternative to OA, particularly in patients with higher BMI or less severe disease presentations. Nonetheless, larger prospective randomized studies are required to confirm these findings and better define the optimal indications for LA in clinical practice.