Background: Complicated appendicitis is often associated with numerous postoperative risks, making it a challenging surgical complication. Laparoscopic appendectomy is commonly performed for uncomplicated cases; however, its role in complicated appendicitis is still under investigation. For the purpose of this investigation, the objective is to evaluate the results which follow clinical practices of performing laparoscopic and open appendectomy in patients with complicated appendicitis.

Methods: From November 2017 to November 2018, a comparative observational study was conducted at the Civil Hospital Karachi's Surgical Department. Among the selected patients with complicated appendicitis, 79 ‘of these patients, 39 underwent laparoscopic appendectomy while 40 underwent open appendectomy’. The studied variables included ‘operative time, hospital stay, postoperative pain scores, recovery time, and complications’.

Results: Patients in the laparoscopic group demonstrated lower postoperative pain scores, undertook oral intake sooner, had reduced duration of hospital stay, and resumed normal activities faster relative to patients in the open group. Even though the laparoscopic group took longer to complete the procedure, the additional time was compensated for by the improved recovery after surgery. Wound infection rates and intra-abdominal abscess formation were ‘lower in the laparoscopic group but did not reach statistical significance’.

Conclusion: Laparoscopic appendectomy is a safe and effective approach for complicated appendicitis, offering better recovery and reduced postoperative discomfort. It should be considered the preferred surgical option when feasible and appropriately supported by surgical expertise.

Keywords: Complicated appendicitis, laparoscopic appendectomy, open surgery, postoperative outcomes, hospital stay, surgical site infection