ROLE OF IMAGING IN CHEMOTHERAPY-INDUCED HEPATIC PARENCHYMAL CHANGES

Abstract

Acute appendicitis represents the most frequent indication for emergency surgery worldwide. Appendectomy, the standard treatment, can be performed via open or laparoscopic techniques. Although laparoscopic appendectomy is increasingly preferred due to its minimally invasive nature, its advantages must be weighed against longer anaesthesia duration and increased resource demands, especially in resource-limited settings. Study Design: Comparative Cross-Sectional Study. Setting: Department of Surgery, Mardan Medical Complex, MTI Mardan, Khyber Pakhtunkhwa, Pakistan. The study was conducted from 11 February to 11 July 2026. The study included sixty patients aged 18 to 60 years diagnosed with acute appendicitis who underwent appendectomy. Patients underwent either open appendectomy (n=20) or laparoscopic appendectomy (n=40), with the surgical approach determined by the operating surgeon’s clinical judgment, resource availability, and patient preference. Outcome measures comprised anaesthesia duration, length of hospital stay, time to tolerance of oral intake postoperatively, and postoperative analgesic requirement. We analysed data using IBM SPSS version 26. Independent-samples t-tests were applied for continuous variables, and Chi-Square or Fisher’s exact tests for categorical variables. We defined statistical significance as p < 0.05. The mean age of patients was 30.10 ± 7.22 years; 36 (60.0%) were male, and 24 (40.0%) were female. The laparoscopic group had a significantly longer anaesthesia duration compared to the open group (77.95 ± 10.81 minutes vs. 65.30 ± 7.18 minutes; p < 0.001). Laparoscopic appendectomy was also associated with a significantly shorter hospital stay (1.77 ± 0.46 days vs. 3.67 ± 0.61 days; p < 0.001), earlier tolerance of oral intake (15.51 ± 3.98 hours vs. 27.87 ± 5.57 hours; p < 0.001), and a lower postoperative analgesic requirement (30.0% vs. 70.0%; p = 0.003). Laparoscopic appendectomy is superior to open appendectomy in early postoperative recovery, as indicated by shorter hospital stay, earlier resumption of oral intake, and reduced analgesic requirements, despite longer anaesthesia duration. It may be considered the first-line surgical intervention for selected patients with uncomplicated acute appendicitis in institutions possessing sufficient laparoscopic expertise and resources.