Abstract

Background: Acute appendicitis (AA) is a common surgical emergency with multiple risks. The risk of post operative complications between laparoscopic appendectomy (LA) and open appendectomy (OA) remains controversial. This study examined patients with complicated appendicitis to clarify these differences.
Methods: A retrospective cohort study conducted at King Abdulaziz University Hospital KAUH, Jeddah, Saudi Arabia, included patients aged ≥14 years who underwent LA or OA for AA between 2012 and 2022. Electronic medical records were reviewed using demographic data (age, gender, nationality, body mass index, and smoking) and clinical/surgical information, including operative technique, preoperative imaging [ultrasound (US), computed tomography scan (CT), radiography (X-ray)], laboratory markers [(leukocytosis, C-reactive protein (CRP), bilirubin], American Society of Anesthesiologists score, appendicitis phase, operative time, infection type, hospital stay, follow-up, and postoperative complications (wound infection, abscess, ileus, and hernia).
Results: A total of 478 patients (mean age: 28.5 years) were included. Preoperative imaging included CT (80.6%), X-ray (26.4%), and US (18.9%). Laboratory findings revealed leukocytosis (57.7%) and elevated CRP (9.4%). LA was performed in 72.4% of cases, and OA in 27.6% of patients. Postoperative complications included abdominal pain or tenderness (10.4%) and nausea or vomiting (9.1%). No significant difference in complica tion rates was found between the LA and OA groups. LA was associated with shorter hospitalization and fewer readmissions, with no significant differences in wound infections or postoperative pain.
Conclusion: LA provides advantages in recovery and healthcare utilization with complications comparable to those of OA, supporting its use in managing complicated appendicitis.

Key words: Keywords: comparisons, laparoscopic, appendectomy, appendicitis, tertiary, Saudi.