Appendicoscopy using single-operator cholangioscope in the management of acute obstructive appendicitis: a novel alternative (with video)

Background and Aims: The aim of this study was to investigate the safety and efficacy fi cacy of appendicoscopy using a single-operator cholangioscope (SOC) for the management of acute obstructive appendicitis. Methods: This study describes 110 cases of acute obstructive appendicitis managed with the use of appendicoscopy between January 2021 and June 2023. The success rate (technical + clinical), procedure time, time to abdominal pain relief according to a visual analog scale score, postoperative length of hospital stay, and adverse event rates were recorded and analyzed. Results: The technical success rate of appendicoscopy was 96.4%, and the clinical success rate was 91.8%. The mean +/- standard deviation procedure time was 20.9 +/- 10 minutes. The abdominal pain score at 6 hours after the procedure was <= 3 (visual analog scale method) in 99.1% of patients. The average length of postoperative hospital stay was 3.5 +/- 1.5 days. No adverse events occurred. Conclusions: Appendicoscopy seems to be a feasible and effective alternative therapy for the accurate diagnosis and treatment of acute obstructive appendicitis. (Gastrointest Endosc 2024;100:532-6.)