Randomized study of the value of laparoscopy before appendicectomy

Two groups of 30 women with clinical signs of appendicitis were randomized to immediate appendicectomy or diagnostic laparoscopy. In the latter group, appendicectomy was performed if a diagnosis of acute appendicitis was established or if the appendix could not be visualized. Eleven patients undergoing immediate operation had unnecessary appendicectomy, compared with two having laparoscopy. This difference of 30 per cent (95 per cent confidence interval 11–49 per cent) was significant (P = 0.01). There was no significant difference in postoperative morbidity rate in the two groups. Diagnostic laparoscopy is a useful preliminary investigation in women with clinical signs of acute appendicitis.