Acute appendicitis is one of the most common causes of abdominal emergencies worldwide, with an annual incidence of approximately 96 per 100,000 individuals [1]. It occurs due to the inflammation of the vermiform appendix, often resulting from obstruction by a faecolith, lymphoid hyperplasia, or rarely, tumors [2,3]. If left untreated, appendicitis can progress to complications such as abscess formation, perforation, or peritonitis, significantly increasing morbidity and mortality [4].

The standard treatment for acute appendicitis is appendicectomy, which can be performed through open or laparoscopic techniques. Open appendicectomy, introduced in the 19th century by McBurney, involves a direct incision over the inflamed appendix. While effective, it is associated with larger surgical wounds, longer hospital stays, and higher complication rates [5,6].

Laparoscopic appendicectomy, introduced in the late 20th century, offers a minimally invasive alternative with smaller incisions, reduced post-operative pain, faster recovery, and lower rates of wound infections [7,8]. Despite its advantages, laparoscopic appendicectomy may have limitations in complicated appendicitis cases, such as perforation or abscess formation, due to technical challenges and longer operative times [9].

Several studies have compared the clinical outcomes of open versus laparoscopic appendicectomy. Research suggests that laparoscopic surgery results in shorter hospital stays, fewer post-operative complications, and quicker return to normal activities [10,11]. However, the effectiveness of each procedure may vary based on patient demographics, appendiceal pathology, and surgeon expertise.

The objective of this study is to evaluate the clinical outcomes and post-operative complications associated with open and laparoscopic appendicectomy in patients with acute appendicitis. By analyzing patient demographics, pathological findings, and surgical outcomes, this study aims to determine the preferred surgical approach for better patient management and recovery.

Study Design: This was a retrospective observational study conducted on 100 patients diagnosed with acute appendicitis.

Inclusion Criteria:

• Patients diagnosed with acute appendicitis.
• Patients who underwent either open or laparoscopic appendicectomy.

Exclusion Criteria:

• Patients with pre-existing chronic abdominal conditions.
• Patients with previous abdominal surgeries.

Data Collection: The following parameters were recorded.

• Demographics: Gender, age group.
• Surgical Procedure: Open or laparoscopic appendicectomy.
• Pathology Findings: Inflammation, faecolith, abscess, or perforation.
• Post-operative Complications: Presence or absence of complications.

Statistical Analysis:

Descriptive statistics were used to summarize patient demographics, surgical procedures, and post-operative complications. The chi-square test was used to compare the complication rates between the two procedures, with a p-value <0.05 considered statistically significant.

A total of 100 patients were considered for this study.

Table 1   Gender

Of these, more than half (52 %) patients were male and close to half (48 %) patients were female.

Table 2   Age Group

Nearly two-third of the patients considered for this study (62 %) belonged to the age group 21 – 30 years. About one-fifth of the patients (18 %) were aged 10 – 20 years. More than one-eigth of the total number of patients (14 %) belonged to the age group 31 – 40 years. Only 4 % of the patients were aged 41 – 50 years and the remaining 2 % of the patients were older than 50 years of age.

Table 3   Surgical Procedure

More than half of the patients (58 %) underwent Open Appendicectomy while the remaining patients (42 %) had undergone Laparoscopic Appendicectomy.

Table 4   Pathology

Of the 100 patients considered for this study, nearly three-fourth of the patients (70 %) had Inflammation. Faecolith was observed in nearly one-fourth (23 %) patients. Abscess was present in only (4 %) patients and Perforation was observed in the remaining (3 %) patients.

Table 5   Post-Op Complications

A total of 100 patients were considered for this study. Most of these patients (87 %) had no Post-Op Complications while only (13 %) patients had Post-Op Complications.

Acute appendicitis is a common surgical emergency that requires prompt diagnosis and management to prevent complications such as perforation, abscess formation, or peritonitis. It typically presents with right lower abdominal pain, fever, and leukocytosis, and its management involves surgical removal of the inflamed appendix. The two primary surgical approaches are open and laparoscopic appendicectomy. Laparoscopic appendicectomy has gained popularity due to its minimally invasive nature, offering reduced post-operative pain, faster recovery, and lower rates of wound infections. However, open appendicectomy remains relevant, particularly in cases of complicated appendicitis or when laparoscopic expertise or facilities are unavailable [5,6].

In this study, among the 100 patients diagnosed with acute appendicitis, 58% underwent open appendicectomy, while 42% underwent laparoscopic appendicectomy. The demographic distribution revealed that the majority of the patients (62%) were in the 21–30 years age group, with a slight male predominance (52%). This finding aligns with previous studies indicating that appendicitis predominantly affects young adults, with a peak incidence in the second and third decades of life [7,8].

The most common pathology observed was inflammation (70%), consistent with the typical presentation of appendicitis. Faecolith was noted in 23% of cases, which is a well-established contributing factor for appendiceal obstruction, leading to acute inflammation [9,10]. Abscess and perforation were less frequent, occurring in 4% and 3% of the cases, respectively, suggesting that most patients in this study had uncomplicated appendicitis. This distribution corresponds with previous reports indicating that complicated appendicitis (perforation or abscess) accounts for 5–10% of cases [11,12].

Post-operative complications were observed in 13% of the cases, with a higher incidence in patients who underwent open appendicectomy. This is consistent with existing literature, where open appendicectomy is associated with increased rates of wound infections, longer hospital stays, and more post-operative pain compared to laparoscopic surgery [13,14]. The reduced tissue trauma and smaller incisions in laparoscopic procedures contribute to fewer complications and faster recovery times [15,16].

The findings of this study are in agreement with previous large-scale meta-analyses. A study by Jaschinski et al. reported that laparoscopic appendicectomy had significantly lower rates of surgical site infections (4.3%) compared to open appendicectomy (8.9%) [17]. Similarly, Li et al. demonstrated that laparoscopic appendicectomy resulted in fewer post-operative complications, shorter hospital stays, and faster return to normal activities [18].

The results of this study reinforce the advantages of laparoscopic appendicectomy, particularly in terms of reduced post-operative complications and quicker recovery. However, open appendicectomy remains a valuable option in complicated cases, such as perforation or abscess formation, where laparoscopic surgery may be technically challenging. The study highlights the importance of early diagnosis and prompt surgical intervention to reduce the risk of complications and improve patient outcomes [19,20].

This study demonstrated that laparoscopic appendicectomy resulted in fewer post-operative complications compared to open appendicectomy. The majority of patients belonged to the 21–30 years age group, with inflammation being the most common pathological finding. Laparoscopic appendicectomy was associated with better patient outcomes, making it the preferred option for managing uncomplicated appendicitis. However, open appendicectomy remains necessary in cases of complicated appendicitis or where laparoscopic expertise is unavailable. Early diagnosis and appropriate surgical intervention are crucial in reducing post-operative morbidity and improving patient recovery outcomes.

Ethical Clearance: Ethical Clearance Certificate was obtained from the Institutional Ethics Committee (IEC) prior to commencement of study.

Conflict of Interest: Nil - No conflict of interest

Source of funding: Self

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