Is Laparoscopic Appendectomy the New 'Gold Standard'?

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Abstract
Objectives: To determine the efficacy of laparoscopic appendectomy compared with open appendectomy in patients with acute appendicitis and to compare the morbidity between the two groups. Design: Prospective sampling of 102 patients who underwent diagnostic laparoscopy and laparoscopic appendectomy for acute appendicitis and retrospective hospital chart review of 204 patients who underwent open appendectomy for acute appendicitis. Results: The mean±SD duration of surgery was 83±29 minutes in the laparoscopic group and 64±30 minutes in the open appendectomy group (P<.001). Hospital stay was shorter in the laparoscopic group (P<.04). There was no difference in the complication rate between the patients who underwent laparoscopic appendectomy (13%) and the patients who underwent open appendectomy (11%). The occurrence of postoperative ileus was correlated with the duration of operation (P<.01) but not with laparoscopic appendectomy. Conclusions: The results confirm that laparoscopic appendectomy had a longer time of surgery, a shorter hospital stay, and no difference in complications. Further investigation will likely establish that laparoscopic appendectomy can be considered the "gold standard." (Arch Surg. 1995;130:782-785)

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