Outcomes of Laparoscopic Versus Open Appendectomy in Complicated Appendicitis

Background: Complicated appendicitis is associated with increased morbidity and postoperative complications. The optimal surgical approach between laparoscopic and open appendectomy remains an area of ongoing debate. Objective: To compare the outcomes of laparoscopic versus open appendectomy in patients with complicated appendicitis. Methods: This cross-sectional analytical study was conducted at Department of General surgery saidu teaching hospital Saidu sharif swat from march 2025 to march 2026 including 180 patients diagnosed with complicated appendicitis. Patients were divided equally into laparoscopic appendectomy (n=90) and open appendectomy (n=90) groups. Results: The mean age was 34.7 ± 11.2 years in the laparoscopic group and 36.1 ± 10.8 years in the open group. Operative time was longer in laparoscopic appendectomy (78.4 ± 18.5 vs. 69.7 ± 16.9 minutes; p=0.002). However, laparoscopic surgery resulted in shorter hospital stay (3.9 ± 1.4 vs. 5.8 ± 2.1 days; p<0.001), earlier oral intake (18.6 ± 6.3 vs. 27.4 ± 8.1 hours; p<0.001), and lower postoperative pain scores (3.8 ± 1.2 vs. 5.9 ± 1.5; p<0.001). Surgical site infection was significantly lower in the laparoscopic group (10.0% vs. 24.4%; p=0.01). Open appendectomy independently predicted postoperative complications (aOR 2.74; p=0.005). Conclusion: Laparoscopic appendectomy provides better postoperative recovery and lower complication rates than open appendectomy in patients with complicated appendicitis despite a slightly longer operative time

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