LAPAROSCOPIC VERSUS OPEN SURGERY FOR CLINICALLY DIAGNOSED APPENDICITIS, EXPERIENCE OF A SINGLE ACADEMIC INSTITUTION IN WESTERN REGION, SAUDI ARABIA

Aim: The role of laparoscopic appendectomy in surgical training is unclear. Although laparoscopic 
appendectomy as a therapeutic modality is potentially superior to open surgery, it has failed to become 
established as standard in training hospitals. The aim of This study to know approach to patients with 
suspected appendicitis in teaching institution at western region of Saudi Arabia, and to compare outcome of 
open versus laparoscopic appendectomy. 
Methods: A retrospective study of 566 appendectomies performed at King Abdulaziz hospital over three 
years (January 2006-December 2008) was undertaken. Demographic, clinical, laboratory data were collected. 
Results: During study period out of 566 patients; 441 (77.9%) patients underwent open appendectomy, 115 
(20.3%) patients underwent laparoscopic appendectomy, and 10 (1.8%) patients converted to open with 
difference between them (p<0.000). Operative finding in open and laparoscopic appendectomy was mostly 
inflamed appendix (77.2%, 80.9%). In laparoscopic appendectomy, operative time was longer (p<0.000), while 
hospital stay was shorter (p<0.000) versus open appendectomy. Postoperative complications (wound 
infection, traumatic injury, intra-abdominal abscess) were not significantly differ between both groups, 
meanwhile, incisional hernia was only found in laparoscopic patients with difference (p<0.05). 
Conclusions: laparoscopic appendectomy was under utilized as a teaching procedure. Time-to-train should 
not preclude institutions from adopting laparoscopic appendectomy.