الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Complicated appendicitis includes acute appendicitis accompanied either by perforation, periappendicular abscess or appendicular mass. Failed conservative therapy and delay in diagnosis can be considered as the predominant causes of perforation in acute appendicitis. Appendicular perforation has been correlated with a higher complication rate by ten folds after appendectomy. Complicated appendicitis is associated with longer hospital stays and increased morbidity rates. In addition, open approach entails its complications including SSI, incisional hernia and dehiscence of the wound. Hence, the laparoscopic approach is gaining much support as minimally invasive and its benefits of laparoscopic surgery. However, the best operative approach for complicated appendicitis is still in question with consistent controversy in opinions.
Since the introduction of laparoscopic appendectomy, it offered more benefits than open appendectomy and was used for different types of appendicitis. The main advantages of laparoscopic appendectomy incorporate decrease in overall postoperative morbidity, shorter stay at hospital, lesser incidence of wound infection, less post-operative pain, earlier postoperative recovery and quicker return to work than open appendectomy.
Even though, role of laparoscopic appendectomy in cases of complicated appendicitis is still debatable because of reports of longer operative time and higher probability of IAA development postoperative. Meanwhile, regarding length of stay and cost, patients with complicated appendicitis benefited the most from the laparoscopic approach.
Our study aimed to compare the outcomes of laparoscopic versus open appendectomy in cases of complicated appendicitis as regard the postoperative pain, postoperative morbidity, postoperative ileus, length of stay at hospital, follow up for one month postoperative and the need for readmission.
The study was carried out on forty patients who were admitted from emergency department to GIT surgery unit, Faculty of Medicine, Alexandria University with complicated appendicitis. Patients were randomly divided into two groups using closed envelope technique: group A which was managed by laparoscopic appendectomy and group B which was managed by the traditional open appendectomy. Patients who had contraindication to laparoscopy or haven’t met the inclusion criteria were excluded from the study.
All patients were subjected to full history taking, clinical examination, laboratory and radiological investigations.
Laparoscopic approach should be considered in the context of complicated appendicitis as a valuable way of management for its benefits, better clinical outcomes and lesser complications than classi