Purpose: Acute appendicitis is one of the most common surgical emergencies worldwide. Laparoscopic appendectomy (LA) is being accepted as the ‘gold standard’ surgery for simple acute appendicitis over open appendectomy (OA); however, for complicated appendicitis, no consensus has been reached with regard to which produces better outcomes. Methods: We analyzed the data of patients who were diag-nosed as complicated appendicitis, older than 18 years old, and underwent LA or OA from January 2008 to December 2012. A total of 2,173 patients had acute appendicitis during this period and 461 (21.2%) of them had complicated appendi-citis; 335 patients were finally enrolled and divided into LA (280), OA (49), and Converted to open Appendectomy (CA) groups (6), respectively. Age, sex, preoperative WBC, operat-ing time, stapler usage, time to diet and discharge, total cost and complication among the three groups were analyzed. Results: No significant differences were observed in sex, age, history of abdominal surgery, preoperative WBC, and total cost. Shorter operating time (62.3±30.0 vs 87.3±40.2, p=0.000), shorter time to diet (2.7±2.2 vs 3.7±1.6, p=0.001), shorter postoperative stay (4.8±2.6 vs 7.1±2.5, p=0.000), shorter duration of pain (3.4±1.7 vs 5.6±2.8, p=0.000), and less frequent usage of pain killer (68.2% vs 89.1%, p＜0.001) were observed in the laparoscopic group. Complication rate was significantly lower in the LA group (4.6% vs 18.4%, p=0.002). Conclusion: Results of this study provide clinical evidence that laparoscopic surgery is a feasible and safe surgical modal-ity for complicated appendicitis. Conduct of more reliable, large scaled, randomized prospective study will be necessary in or-der to prove the superiority of laparoscopic surgery for compli-cated appendicitis.

Keywords: Appendicitis, Appendectomy, Laparoscopy