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Introduction: Although laparoscopic appendectomy is being performed with increased frequency, the utilization of laparoscopy in the management of acute appendicitis remains controversial and it continues to be used selectively. Objectives: Our study was intended to evaluate retrospectively outcomes of laparoscopic appendectomy (LA) versus open appendectomy (OA) in perforated and non-perforated appendicitis in adults (between age18 to 65years old).Methods: Using the Nationwide Inpatient Sample database (NIS), clinical data of adults who underwent LA and OA for suspected acute appendicitis (perforated and non-perforated) was evaluated from 2006 to 2008. Incidental and elective appendectomies were excluded. Outcome measures included patient characteristics (age, sex and race), comorbidities, postoperative complications, length of hospital stay (LOS), total hospital charges and in-hospital mortality. Results: A total of 573,244 adult underwent urgent appendectomy during these three years (67.31% of all appendectomies). 45.9% of patients were female and 69.5% Caucasian. The mean age was 37 years. In overall, 65.21% of all appendectomies were performed laparoscopically. LA was performed more in female than male (67.64% vs.63.15% p<0.01). The rate of perforated appendicitis was lower in female (21.96% vs. 26.09%, p<0.01). The table shows outcomes of OA and LA in non-perforated and perforated appendicitis in adults.Conclusion: LA is safe and associated with lower morbidity, lower mortality and shorter hospital stay with acute perforated and non-perforated appendicitis. Also, in perforated cases LA had an advantage over OA in hospital charges. Laparoscopic appendectomy should be considered the procedure of choice for perforated and non-perforated appendicitis in adults
Outcomes of Laparoscopic and Open Appendectomy in Non-perforated and Perforated Appendicitis

	Non-perforated			Perforated
	LA	OA	P-value	LA	OA	P-value
Overall Complication (%)	4.60	7.59	<0.001	22.30	35.33	<0.001
Wound Infection (%)	0.15	0.42	<0.001	0.58	2.09	<0.001
Intra-abdominal Abscess (%)	0.26	0.76	<0.001	1.65	3.57	<0.001
Mean Lenght of Hospital Stay (days)	1.66	2.40	<0.001	4.04	5.99	<0.001
Mean Hospital Charges (\0	22,830	20,849	<0.001	32,313	38,319	<0.001
In-hospital Mortality (%)	0.03	0.05	<0.001	0.06	0.31	<0.001

LA: Laparoscopic Appendectomy OA: Open Appendectomy