Is Laparoscopic Appendectomy Recommended in Perforated Appendicitis?

Objective: To compare Open Appendectomy and Laparoscopic Appendectomy in the treatment of perforated Appendicitis. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Abbottabad Pakistan, from Dec 2016 to Jan 2022. Methodology: A total of 240 patients underwent either open (Group-A) or laparoscopic (Group-B) appendectomy. Patients of Perforated Appendicitis fulfilling inclusion criteria were included in the study after getting informed consent. Variables of operative time, hospital stays, surgical site infection and Intra-abdominal infection were recorded. Results: Mean operating time for the Open Appendectomy-Group (49.7±6.10 minutes) was significantly shorter than the time of Laparoscopic Surgery-Group (58.93±5.41 minutes; p<0.001). The mean hospitalization time was shorter (2.57±0.77 days) in Laparoscopic Appendectomy than Open Surgery-Group (3.23±0.62 days, p=0.001).  Two port sites (6.7%) in the Laparoscopic Group and nine surgical sites (30.0%) in the Open Surgery-Group got infected (p=0.021). Two patients (6.7%) in Open Appendectomy-Group and three patients (10.0%) in Laparoscopic Appendectomy-Group had postoperative complication of intra-abdominal abscess (p=1.00). Conclusion: As compared to open approach, laparoscopic appendectomy had significantly lesser surgical site infections, shorter hospital stays and longer operating time. There was no statistically significant difference in the intra-abdominal infection in both techniques.