A Study of Open Versus Laparoscopic Appendicectomy

Background:Appendicectomy has been the treatment of choice for acute appendicitis. Since advent Laparoscopic appendicectomy (LA) has struggled to prove its superiority over the open technique. This is in contrast to laparoscopic cholecystectomy, which has promptly become the gold standard for gallstone disease. Open appendicectomy (OA) has withstood the test of time for more than a century. The procedure is standardized among surgeons and unlike cholecystectomy, OA is typically completed using a small right lower quadrant incision and postoperative recovery is usually uneventful. Hence there a need to compare both in terms of efficacy and other issues. Methodology: The primary objective of this study is to compare the results of LA with that of OA in terms of operating time, post-operative pain, wound infection, duration of hospital stay and time to return to usual activities. The secondary objective is to study the intra-operative factors causing conversion of LA to OA. Observational comparative study between two groups ie Open appendicectomy group and Laparoscopic appendicectomy group during period of Jan 2014 to Dec 2016 in a tertiary care teaching hospital results were analysed and conclusions were made with respect to post operative pain, stay, conversions etc Results and conclusion: A Total of 192 cases included in the study of which 100 manged by open appendicectomy and 85 by laparoscopic appendicectomy 7 were excluded from the study as lap converted to open so primary analysis cannot be interpreted. Most of the cases were males most common cause of conversion is difficulty in identification of appendix due to anatomy or technique of approach. There is no much of differences between outcomes and laparoscopic is little advantageous in view of less post operative pain and early recovery and post op wound infections requiring interventions are relatively low however Cost factor and of-course in cases with peritonitis open appendicectomy is preferred.