Appendectomy For Complicated Appendicitis Research Articles

Laparoscopic appendectomy in complicated appendicitis with compromised appendix base: a retrospective cohort study

Laparoscopic appendectomy in complicated appendicitis with compromised appendix base: a retrospective cohort study

Safety of Laparoscopic Appendectomy in Complicated Appendicitis in children

ABSTRACT
 INTRODUCTION: Acute appendicitis is one of the most common surgical emergency in pediatric age group. Laparoscopic Appendectomy (LA) is no more a new procedure in pediatric surgery. The idea behind laparoscopy is short hospital stay, minimal complications and better cosmesis especially in overweight and obese patients. Laparoscopy offers detailed and magnified visualization and better access into the whole abdominal cavity. In many pediatric surgery centers, laparoscopic management of acute appendicitis is practiced but we have observed that most of them performed laparoscopic appendectomy for simple straight forward appendicitis. It is generally considered that complicated appendicitis is better managed by open procedure. We have performed laparoscopy in 42 patients of Complicated Appendicitis (CA) and observed that the rate of complication is comparable to the known reported studies.
 OBJECTIVE: The objective of this study was to establish safety of laparoscopic appendectomy in complicated appendicitis in children
 STUDY DESIGN: It was a retrospective study.
 SETTING: Research was conducted at Department of Pediatric Surgery, Shifa International Hospital Islamabad.
 DURATION: Duration of study was 3 years after due approval from ethical and research review board.
 MATERIAL AND METHODS: The present study is a retrospective analytical review of 42 patients who were operated for complicated appendicitis laparoscopically at Shifa International Hospital, Islamabad from January 2018 to December 2020.
 All patients were enrolled from emergency department. Clinical assessment of the patients were done in the routine way by history and physical examination. Investigations included complete blood count, C reactive protein and ultrasound abdomen and pelvis. Those patients were excluded from the study who had simple non-complicated appendicitis, open appendectomy, those who had laparotomy for other reasons and interval appendectomy. Similarly those patients who were COVID positive were excluded from the study.
 All those patients who had complicated appendix like perforation, abscess, mass or gangrene were included in the study.
 Variables observed in this study were age, sex, operative findings, operative time, hospital stay and post op complications.
 RESULTS: From January 2018 to December 2020, total 42 patients were included in this study who underwent laparoscopic appendectomy for complicated appendicitis. Complicated appendicitis includes perforated appendicitis, abscess, mass or gangrene. Mean age of the patients was 9.95 with standard deviation of 3.22. Of 42 patients in total, 32 (76%) patients were male and 10 (24%) were female. Mean operative time was 42.5min with standard deviation of 20.03. Mean hospital stay time was 2.23 days with standard deviation of 1.55 (table 1).
 Out of total 42 patients, 20 (48%) had perforated appendicitis, 9 (21%) patients had appendicular mass, 12 (29%) patients had appendicular abscess and 1 (2%) patient had gangrenous appendicitis. Postoperatively, one patient of perforated appendicitis had trocar site infection. One patient had mass formation with partial obstruction and post-operatively developed urinary retention with peri-orbital puffiness. Two patients of appendicular mass had transaction of appendicular base due to perforated and sloughed appendicular base. One patient of appendicular abscess had large collection in right paracolic gutter. One patient of appendicular abscess developed peritonitis with abscess formation secondary to cecal perforation.
 CONCLUSION: Our experience with laparoscopy in appendicitis revealed that for complicated appendix laparoscopy is very safe in children with only fewer complications. Although our sample size is small but in our 3 last year experience we learned that laparoscopy may safely be done as a first choice in all patients with appendicitis, whether simple or complicated. Our experience indicates that the apprehension amongst the treating surgeons is not very justified as we routinely do laparoscopy in all appendicitis.
 KEY WORDS: Laparoscopic appendectomy, complicated appendicitis.

Post-Operative Outcomes of Laparoscopic Appendectomy in Acute Complicated Appendicitis: A Single Center Study.

Acute appendicitis (AA) is a surgical emergency because of inflammation in the appendix leading to swelling, whereas acute complicated appendicitis is characterized by a gangrenous or perforated appendix with or without periappendicular abscess, peritonitis, and an appendicular mass. The laparoscopic approach in complicated acute appendicitis is a viable alternative method but is not practiced in all cases because of technical difficulties and unpredictable complications. Thus, the present study aimed to evaluate the primary and secondary outcome predictors of laparoscopic appendectomy in complicated appendicitis. A single-center prospective observational study was carried out after the approval of the Institutional Ethics Committee (IEC). A total of 87 complicated acute appendicitis patients were included in the study. Clinico-demographic features such as age, gender, duration of surgery, post-operative pain, and hospital stay were monitored in different age groups of <20, 20-39, and >40 years, and the primary and secondary outcomes of laparoscopic surgery in acute complicated appendicitis were measured. Acute complicated appendicitis cases were observed mostly in people older than 42 years in the total study population. Laparoscopic appendectomy was conducted in all 87 acute complicated appendicitis patients, and the major surgical outcome predictors were monitored, such as mean operating time (87.9 minutes), post-operative pain (3.9 scores), and post-operative stay (6.7 days). Post-operative complications such as drain site infection (1.14%), enterocutaneous fistula (2%), and intra-abdominal abscess (7%) were observed. Based on our observations, a laparoscopic appendectomy can be considered a viable alternative with an acceptable complication rate. Operative time varies from 84 to 94 minutes in different age groups and with the extent of the disease.

Clinical Outcomes of Laparoscopic Appendectomy in Complicated Appendicitis among Young Children

Background and Aim: Despite the good outcomes associated with laparoscopic appendectomy for uncomplicated appendicitis, the benefits of this procedure for complicated appendicitis are less obvious due to increased infection risk. The current study aims to assess the effectiveness of laparoscopic appendectomy in children with complicated appendicitis. Patients and Methods: This retrospective study was conducted on 92 complicated appendicitis cases among young children (&lt;8 years) in the department of Surgery, Lady Reading Hospital, Peshawar for the period from January 2022 to June 2022. Prior to study conduction, surgical consent was provided by each individual. Demographic details such as age and gender, operative time, hospital stay, operative finding, postoperative complications, bowel function return, and oral feed resumption were recorded. Results: Of the total 92 cases, 52 (56.5%) were male and 40 (43.5%) were females. The overall mean age was 5.9±0.8 years with an age range from 4.2 to 7.8 years. Among the total cases, 88 (95.7%) underwent complete laparoscopic appendectomy whereas 4 (4.3%) patients needed conversion to open appendectomy. The mean length of hospitalization was 4.8±3.3 days. The operation took 72.8±26.4 minutes. In terms of postoperative complications, the incidence of post-operative ileus, superficial wound infections, and intra-abdominal collections developed in 4 (4.3%), 2 (2.2%), and 6 (6.5%) respectively. There was no death recorded. Conclusion: The present study concluded that children with complicated appendicitis can benefit from laparoscopic appendectomy. In addition to its feasibility, safety, rapid recovery and good cosmetic results, this procedure is associated with minimal post-operative morbidity. Keywords: Complicated appendectomy, Laparoscopic appendectomy, Clinical outcomes

AbcApp: incidence of intra-abdominal ABsCesses following laparoscopic vs. open APPendectomy in complicated appendicitis

BackgroundPatients with complicated appendicitis are more at risk for the occurrence of postoperative intra-abdominal abscesses than patients with uncomplicated appendicitis. Studies comparing laparoscopic and open appendectomy showed limitations and contradictory findings on the incidence of intra-abdominal abscesses after appendicitis, as most of these studies analysed both uncomplicated and complicated appendicitis as one group. The aim of the present study is to investigate the incidence of intra-abdominal abscesses after laparoscopic versus open appendectomy for complicated appendicitis.MethodsA retrospective cohort study was performed over the period January 2009 till May 2020. All patients who had an intra-operative diagnosis of complicated appendicitis (e.g. perforation, necrosis) were included. The outcome measure was the occurrence of intra-abdominal abscesses with a postoperative follow-up of 30 days. Multivariate logistic regression analysis was performed including adjustments for significant confounders.ResultsA total of 900 patients had undergone appendectomy for complicated appendicitis. The majority was operated laparoscopically (78%, n = 705). The incidence of postoperative intra-abdominal abscess was 12.3% in both laparoscopic and open appendectomy groups. On univariable analysis, the postoperative rates of intra-abdominal abscesses between laparoscopic and open appendectomy were not significantly different (odds ratio 1.11, 95% CI [0.67–1.84], p = 0.681).ConclusionThe present study provides evidence that, in current daily practice, intra-abdominal abscess formation remains a common postoperative complication for complicated appendicitis. Nonetheless, no significant difference was found with regard to intra-abdominal abscess formation when comparing laparoscopy with open surgery.

A Prospective Study Comparing Laparoscopic with Open Appendectomy in Children with Complicated Appendicitis

Background: Due to the difficulty of performing minimally invasive surgery in a region of distorted anatomy and significant inflammation, the decision to do laparoscopic appendectomy in pediatric patients with complicated appendicitis has been controversial. The main advantages of laparoscopic appendectomy in complicated appendicitis, according to several studies, are wound infection avoidance and shorter hospital stays. The study’s goal is to investigate and compare various clinical outcomes in children with complicated appendicitis who were treated with laparoscopic appendectomy versus those treated with open appendectomy to determine the value of laparoscopic appendectomy in pediatric patients. Methods: A prospective randomized controlled clinical trial was done at a single center in TAIF, Saudi Arabia. The study included children aged 14 years or less who were diagnosed with complicated appendicitis. All collected preoperative findings, investigations, type of surgery, operative findings and time, postoperative complications, antibiotic course, length of hospital stay, time to start oral intake, and histopathology report were analyzed. Results: Operative time was significantly longer in the Laparoscopic Appendectomy (LA) group (73.1 min) than in the Open Appendectomy (OA) group (63.4min) (p=0.0344), while the total hospitalization duration was significantly shorter in the LA group (4.51days) in comparison with the OA group (5.94 days) (p=0.0001). In addition, a statistically significant difference was noted in the resumption of oral intake which was significantly faster in the LA vs OA group (2.1 days) vs (3.4 days) (p=0.0001). We observed that patients in the OA group had a higher rate of incidence of surgical site infection (SSI), which is statistically significant (p= 0.0389). Conclusions: Our study shows that laparoscopic appendectomy in the expert hands for the management of complicated appendicitis in the pediatric population is considered safe and feasible and should be considered a first choice. Keywords: Children, complicated appendicitis, open appendectomy, Laparoscopic Appendectomy.

Comparative study between Open Surgical Technique versus Laparoscopic Appendectomy in Complicated Appendicitis

Comparative study between Open Surgical Technique versus Laparoscopic Appendectomy in Complicated Appendicitis

Amoxycillin/Clavulanic acid monotherapy in complicated paediatric appendicitis: Good enough?

BackgroundAntibiotic choice for complicated appendicitis should be based on both microbiological effectiveness as well as ease of administration and cost especially in lower resourced settings. Data is limited on comparative morbidity outcomes for antibiotics with similar microbiological spectrum of activity.Incidence and morbidity of surgical site infection after appendectomy for complicated appendicitis was assessed after protocol change from triple antibiotic (ampicillin, gentamycin, and metronidazole) regimen to single agent (amoxycillin/clavulanic acid). MethodsSurgical site infection (SSI) rate, relook surgery rate and length of hospital stay were retrospectively compared in patients treated for acute appendicitis preceding (2014, 2015; “triple-therapy, TT”) and following (2017, 2018; “single agent, SA”) antibiotic protocol change. ResultsThe rate of complicated appendicitis was similar between groups; 72.6% in TT and 66% in SA (p = 0.239). Significantly, SSI occurred in 22.7% of the SA group compared to 13.3% in TT group (OR 1.920, 95% CI 1.000–3.689, p = 0.048).Use of laparoscopy increased from 31% in TT to 89% in SA, but with subgroup analysis this was not associated with increased SSI (17.3% in open and 20.6% in laparoscopic; OR 0.841, 95% CI 0.409–1.728, p = 0.637). Relook rate (OR 1.444, 95% CI 0.595–3.507, p = 0.093) length of hospital stay (U = 6859, z = -1.163, p = 0.245), and ICU admission (U = 7683, z = 0.634 p = 0.522) were equivocal. Neither group had mortalities. ConclusionsDespite increased SSI with SA, overall morbidity relating to ICU admission, relook rate and length of hospital stay was similar in both groups. More prospective research is required to confirm equivalent overall morbidity and that single agent therapy is more cost-effective with acceptable clinical outcomes.

Is Abdominal Drain Necessary after Laparoscopic Appendectomy for Complicated Appendicitis?

Is Abdominal Drain Necessary after Laparoscopic Appendectomy for Complicated Appendicitis?

Mastering the learning curve significantly reduces operative time for laparoscopic treatment of complicated appendicitis

Laparoscopic appendectomy is the preferred operative method for acute appendicitistreatment. In terms of complicated appendicitis it can be effective in hands of an experiencedlaparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospectivestudy examines whether the operative time for laparoscopic appendectomy for complicatedappendicitis is shortened after mastering the learning curve. Material and methods: A totalnumber of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77were diagnosed with complicated appendicitis. They were subsequently divided in two groups(laparoscopic and open). Operative time in both groups was measured and the conversionand postoperative complications were noted. Results: Conversion rate was 2.3%. Operativetime was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033).Overall postoperative morbidity was 25.97% with wound infection present only in the opengroup (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopicgroup (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).

Reduction of surgical site infections in pediatric patients with complicated appendicitis: Utilization of antibiotic stewardship principles and quality improvement methodology

BackgroundThe rate of surgical site infection (SSI) after appendectomy for complicated appendicitis (CA) was high at our children's hospital. We hypothesized that practice standardization, including obtaining intra-operative cultures of abdominal fluid in patients with CA, would improve outcomes and reduce healthcare utilization after appendectomy. MethodsA quality improvement team designed and implemented a clinical practice guideline for CA that included obtaining intra-operative culture of purulent fluid, administering piperacillin/tazobactam for at least 72 h post-operatively, and transitioning to oral antibiotics based on intraoperative culture data. We compared outcomes before and after guideline implementation. ResultsFrom July 2018-October 2019, 63 children underwent appendectomy for CA compared to 41 children from January-December 2020. Compliance with our process measures are as follows: Intra-operative culture was obtained in 98% of patients post-implementation; 95% received at least 72 h of piperacillin-tazobactam; and culture results were checked on all patients. Culture results altered the choice of discharge antibiotics in 12 (29%) of patients. All-cause morbidity (SSI, emergency department visit, readmission to hospital, percutaneous drain, unplanned return to operating room) decreased significantly from 35% to 15% (p=0.02). Surgical site infections became less frequent, occurring on average every 27 days pre-implementation and every 60 days after care pathway implementation (p=0.03). ConclusionsUtilization of a clinical practice guideline was associated with reduced morbidity after appendectomy for CA. Intra-operative fluid culture during appendectomy for CA appears to facilitate the selection of appropriate post-operative antibiotics and, thus, minimize SSIs and overall morbidity.

Does abdominal drainage improve outcomes after open appendectomy for complicated appendicitis?

Does abdominal drainage improve outcomes after open appendectomy for complicated appendicitis?

Efficacy of Laparoscopy versus Open Surgical Appendectomy in Complicated Appendicitis

Efficacy of Laparoscopy versus Open Surgical Appendectomy in Complicated Appendicitis

Assessment of the Outcomes of Laparoscopic Versus Open Appendectomy: A Cross-sectional Study

Introduction: We conducted a cross-sectional study in two institutions for reviewing the postoperative complications of laparoscopic appendectomy vs open appendectomy for complicated appendicitis. The primary objectives were detection of surgical site infection and reoperation within 30 days postoperatively. The secondary objectives were reducing the length of hospital stay, increasing patient satisfaction level, and identifying other diseases and postoperative complications like pneumonia, deep vein thrombosis, bedsores, and enterocutaneous fistulas. Materials and Methods: We analyzed 683 patients that met the inclusion criteria and their clin- ical data and hospital costs. The patients were divided into two groups: open appendectomy (OA) group and laparo- scopic appendectomy (LA) group. The collected clinical data included demographic data, co-morbidities, initial laboratory findings, operation time, intraoperative findings (acute, gangrenous or perforated appendix), time to soft diet, postoperative hospital stay, amount of analgesics and postoperative complications. Results: The laparoscopic group required fewer doses of paren- teral and oral analgesics in the operative and post- operative periods compared with the open appendectomy (P &lt;0.0001). Bowel movements in the first postoperative day were observed in 93.5% patients subjected to laparoscopic appendectomy and 68.1% in the open group (P &lt;0.001). As a result, 86.8% patients in the laparoscopic group and 61.1% in the open group were able to toler- ate a liquid diet within the first 24 postoperative hours (P &lt;0.001). Conclusion: Our results showed the advantages of the laparoscopic approach over open appendectomy including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection, against only marginally higher hospital costs. Furthermore we found a considerable preference (during the collection of consent) of patients and a high satisfaction after the surgery in the laparoscopic group.

Laparoscopic versus open appendectomy in complicated appendicitis in children: a single center study

BackgroundAcute complicated appendicitis is a common abdominal emergency in children. Unlike simple appendicitis, laparoscopic appendectomy has not been considered yet the first choice in management of complicated appendicitis. This prospective randomized controlled clinical trial was conducted at Pediatric Surgery Department, Zagazig University Hospitals, Egypt, during the period from December 2018 to August 2019. The aim of the study was to evaluate the role of laparoscopic appendectomy in such cases compared to open appendectomy.ResultsSixty patients were included in the study, divided randomly into 2 equal groups: laparoscopic and open appendectomy groups. The mean operative time was significantly longer with laparoscopic appendectomy than open appendectomy, 85 vs. 61 min, respectively (p < 0.001**). The time taken to start oral intake was significantly shorter with laparoscopic appendectomy than open appendectomy, 1.9 vs. 2.73 days, respectively (p = 0.025*). The mean hospital stay was significantly lower with laparoscopic appendectomy than open appendectomy, 4.23 vs. 5.13, respectively (p = 0.044*). There were no statistical differences between the two groups regarding wound infection, occurrence of postoperative ileus, intraperitoneal collection, or readmission.ConclusionsLaparoscopic appendectomy is safe, feasible, and effective procedure in the management of complicated appendicitis in children, with no evidence of any increase in the postoperative complications.

Surgical outcomes in patients with complicated appendicitis treated in medical college &amp; hospital

Background and Aim: Complicated appendicitis has got good overall prognosis. Overall mortality rate of complicated appendicitis is less than 1%. Appendectomy is the most common surgical procedure done worldwide. Hence the aim of the present study was to assess the safety and efficacy of laparoscopic appendectomy in complicated appendicitis. Materials & Methods: Total of 60 patients was include in the study. Data of the patients with age, sex, symptoms were tabulated. The documentation of the clinical findings, biochemical and imaging findings were done. Ultrasonography of the abdomen and pelvis was done in all the children. CT as ordered in those cases where the USG was found to be inconclusive. Results: Wound infection was managed conservatively with daily dressings. Late complication in the form of adhesive obstruction was seen in 10 patients. Adhesive obstruction was seen between 6 weeks to 6 months post-surgery. Four patients required re-surgery for adhesive obstruction. In 6 children, adhesive obstruction was managed conservatively with intravenous fluids, antibiotics and nil per oral. Conclusion: Early surgery makes the patient to get back to normal activities sooner and also reduces financial burden on family. Preliminary results show that our experiences with Laparoscopic appendectomy in Complicated Appendicitis in children have been encouraging. In conclusion having found less morbidity with laparoscopic approach we advocate the use of laparoscopy in children even with complicated appendicitis.

Does abdominal drainage improve outcomes after open appendectomy for complicated appendicitis?

Does abdominal drainage improve outcomes after open appendectomy for complicated appendicitis?

A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study

BackgroundAppendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA).MethodsData for 179 patients who underwent an operation for the treatment of complicated appendicitis at our hospital between 2011 and 2017 were retrospectively analyzed. The selection included 89 patients who underwent a conventional appendectomy and 90 patients who were treated laparoscopically. Outcome measures such as mean operative time, blood loss, time until oral intake duration of hospital stay, and postoperative complications were analyzed. Logistic regression analysis was performed to determine the concurrent effects of the examined factors on the rate of postoperative complications.ResultsThe mean ages of patients in the OA and LA groups were 50.17 ± 22.77 and 50.13 ± 25.84 year. Mean operative times were longer in the LA group than OA (10.2.56 ± 44.4 versus 85.4 ± 43.11 min; p = 0.009). The duration of hospital stay was shorter for the LA group (9.61 ± 5.57 versus 12.19 ± 8.4; p = 0.016). There were no significant differences in return to consumption of oral intake between the LA and OA groups (2.03 ± 1.66 versus 2.48 ± 2.17; p = 0.123). Multivariable analysis found that the rate of postoperative complications was significantly reduced for the LA group, in comparison with the postoperative-complication rate of the OA group (16.7% versus 27%; odds ratio 0.376; 95% CI 0.153–0.923; p = 0.0327).ConclusionsThese results suggest that LA is a safe and efficient operative procedure that provides clinically beneficial advantages in comparison with OA. Thus, when possible, appendectomy for complicated appendicitis should be attempted using a laparoscopic approach.Trial registrationRetrospectively registered.

Analysis of Outcomes Using Intraoperative Irrigation and Drainage for Complicated Appendicitis

Background: The practice of irrigation and/or intraoperative peritoneal drain placement during an appendectomy for complicated appendicitis is currently controversial. This study was aimed at delineating the relationship between the practice of intraoperative drain placement and/or irrigation and patient outcomes for complicated appendicitis cases. Methods: A retrospective study of patients presenting with acute complicated appendicitis, which was defined as perforated or gangrenous, was conducted (n = 225). The primary outcome was defined as the presence of postoperative abscess or sepsis, while the secondary outcome measured was length of hospital stay. Results: Patients who received intraoperative drain placement had an increased risk of postoperative abscess (odds ratio (OR) = 13.33, P < 0.001) and sepsis (OR = 11.37, P = 0.026). There was no significant difference in primary outcomes with irrigation. Patients who received irrigation had a longer length of stay (7.59 vs. 4.69 days, P = 0.001) as did those who received an intraoperative drain (7.61 vs. 5.33 days, P = 0.01). Conclusions: In this study, irrigation did not change the OR of sepsis and postoperative abscess. However, placement of an intraoperative drain increased both the rates of sepsis and postoperative abscesses, indicating possible increase in postoperative complications with intraoperative drains when compared with no drains. J Curr Surg. 2019;9(2-3):17-21 doi: https://doi.org/10.14740/jcs385 Â

Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.