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CC BY 4.0 · Endosc Int Open 2025; 13: a26386177
DOI: 10.1055/a-2638-6177
Original article

Direct visualization endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for management of acute uncomplicated appendicitis

Jun-yu Pan 
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
Hui-xin Zhi
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
Jie-li Chen
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
Hao-xin Chen
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
De-feng Li
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
Jun Yao
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
,
Li-sheng Wang
1   Department of Gastroenterology, The Second Clinical Medical College of Jinan University, Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China, shenzhen, China
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Gefördert durch: Technical Research and Development Project of Shenzhen 202408133000954
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Erratum zu diesem Artikel:

Correction: Direct visualization endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for management of acute uncomplicated appendicitisEndosc Int Open 2025; 13(CP):
DOI: 10.1055/a-2684-7813

Abstract

Background and study aims

Direct visualization endoscopic retrograde appendicitis therapy (ERAT), an advanced technique building upon conventional ERAT, represents a novel endoscopic approach for managing acute uncomplicated appendicitis. This study aimed to assess clinical efficacy and safety of employing cholangioscope-guided endoscopic intervention as a therapeutic approach.

Patients and methods

A retrospective analysis was conducted on 656 patients presenting with suspected acute appendicitis between February 2024 and November 2024. To minimize baseline differences, propensity score matching was applied, resulting in a final study population of 34 patients undergoing direct visualization ERAT and 68 patients treated with laparoscopic appendectomy (LA). Key outcome measures included technical and clinical success rates, operative time, time to postoperative pain resolution, length of hospital stay, recurrence rate, incidence of adverse events (AEs), and overall patient satisfaction.

Results

The technical success rate was 97.06% (33/34) in the ERAT group and 100% in the LA group (P = 0.333), while clinical success was achieved in 94.12% (32/34) of ERAT cases compared with 100% in the LA cohort (P = 0.109). Notably, ERAT was associated with a significantly shorter operative time (37 vs 50 minutes; P < 0.001) and more rapid postoperative pain relief (P = 0.001), with a greater proportion of patients reporting complete symptom resolution within 2 days of the procedure. There were no significant differences between the two groups in terms of AEs, length of hospital stay, or patient satisfaction. During follow-up, a recurrence of appendicitis was observed in one ERAT patient (2.94%, 1/34).

Conclusions

Direct visualization ERAT demonstrated high feasibility and effectiveness as a diagnostic and therapeutic modality for acute uncomplicated appendicitis, offering a promising alternative to conventional approaches.

Keywords

Endoscopy Lower GI Tract - Stenting - Pancreatobiliary (ERCP/PTCD) - Cholangioscopy


Publikationsverlauf

Eingereicht: 27. Dezember 2024

Angenommen nach Revision: 05. Juni 2025

Artikel online veröffentlicht:
07. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Jun-yu Pan, Hui-xin Zhi, Jie-li Chen, Hao-xin Chen, De-feng Li, Jun Yao, Li-sheng Wang. Direct visualization endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for management of acute uncomplicated appendicitis. Endosc Int Open 2025; 13: a26386177.
DOI: 10.1055/a-2638-6177
 

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