To explore the safety and efficacy of laparoscopic appendectomy for acute appendicitis with an onset time >72 hours.

The clinical data of 675 cases with acute appendicitis treated by laparoscopic surgery from January 2013 to October 2019 in Angang Group General Hospital were retrospectively analyzed. According to the onset time, they were divided into 158 cases in the >72 h group and 517 cases in the ≤72 h group. The pathological characteristics, proportion of antibiotics used, operation and postoperative complications between the two groups were compared.

The pathological types between the two groups showed no statistically significant difference (χ2=23.690, P=0.002), and no serious complications occurred after operation. Compared with the≤72 h group, the patients in the >72 h group had a higher proportion of antibiotics before admission (94.30% vs 82.21%, χ2=10.361, P=0.037), longer operation time (t=3.998, P=0.029), and the amount of bleeding was more (t=2.368, P=0.035).

Laparoscopic appendectomy is safe and feasible for acute appendicitis patients with an onset time >72 hours, which can avoid secondary hospitalization, shorten the course of disease, reduce hospitalization costs and pain.