Laparoscopic Versus Open Appendectomy: A Meta-Analysis of Postoperative Outcomes and Complications

Abstract

Acute appendicitis remains a major surgical emergency in the world, with appendectomy, which may be laparoscopic (LA) surgery or open (OA) surgery, being the last curative treatment. This meta-analysis, comprising 15 studies published during 2020-2025, includes randomised trials and observational cohorts conducted in various settings, including Pakistan, to compare the effectiveness of LA and OA in uncomplicated and complicated appendicitis. The results have shown that LA has been linked to a significant decrease in postoperative pain, a shorter length of stay, faster recovery of day-to-day functions, and a lower rate of surgical site infection, despite a net increase in operative duration. Transforming LA to OA and especially in complex cases, is associated with the development of high morbidity, prolonged hospitalisation, and increased risk of infection. In turn, the results indicated that the preferential application of LA is justified in case of sufficient resources and expertise, whereas the importance of risk stratification and additional large-scale research under resource-limited conditions is highlighted.