Comparative Study Between Laparoscopic and Open Appendectomy of Complicated Appendicitis

Acute appendicitis is one of the most common surgical emergencies in children. In complicated cases, where the appendix has perforated, become gangrenous, or caused peritonitis and purulent contamination, determining the optimal surgical approach remains an important clinical question. While laparoscopic appendectomy is widely used for uncomplicated cases, this study aims to evaluate its safety, clinical effectiveness, and postoperative outcomes compared with conventional open appendectomy in children with complicated appendicitis. A total of 100 pediatric patients diagnosed with complicated acute appendicitis will participate in this prospective comparative study, divided into two groups: * Group A: 50 patients undergoing laparoscopic appendectomy using a standard minimally invasive three-port technique. * Group B: 50 patients undergoing conventional open appendectomy via a standard right lower-quadrant incision. The primary goal is to compare the overall rate of postoperative complications between the two operative techniques. Researchers will also assess secondary outcomes, including operative time, intraoperative complications, conversion to open surgery, postoperative pain, time to resume oral feeding, duration of intravenous antibiotics, length of hospital stay, wound infections, intra-abdominal abscesses, bowel obstruction, readmissions, and reoperations. All participants will be evaluated during their hospital admission and followed up for 30 days postoperatively.