World Journal of Surgery

, Volume 42, Issue 5, pp 1295–1303 | Cite as

Effects of Timing of Appendectomy on the Risks of Perforation and Postoperative Complications of Acute Appendicitis

  • Jong Wan Kim
  • Dong Woo Shin
  • Doo Jin Kim
  • Jeong Yeon Kim
  • Sung Gil Park
  • Jun Ho Park
Original Scientific Report



It is generally believed that appendectomy should be performed immediately to prevent perforation and complications. Therefore, our objectives were to investigate the effect of timing of appendectomy on the incidence of perforation and complications.


We retrospectively reviewed the medical records of patients who underwent laparoscopic appendectomy between January 2014 and June 2015. The time from symptom onset to appendectomy was categorized into three periods: time from symptom onset to hospital admission (symptomatic time), time from admission to appendectomy (hospitalization time), and time from symptom onset to appendectomy [symptomatic period + hospitalization period (overall time)]. Multivariable analyses were performed to identify independent factors associated with perforation and complications.


A total of 1753 patients were included in the present study. Perforation occurred in 28.2% of patients, and postoperative complications occurred in 10.0% of patients. Multivariable analysis showed that BT > 38 °C (P = 0.006), WBC count >13,000 cells/µl (P = 0.02), neutrophil ratio >80% (P < 0.001), and symptomatic time >24 h (P < 0.001) were independent factors of appendiceal perforation, while the neutrophil ratio >80% (P < 0.001) and symptomatic time >48 h (P = 0.003) were independently associated with complications.


The present study showed that the symptomatic time and overall time were significantly associated with perforation and complications, whereas hospitalization time was not associated with either perforation or complications.



This research was supported by Hallym University Research Fund 2016(HURF-2016-52).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Jong Wan Kim
    • 1
  • Dong Woo Shin
    • 1
  • Doo Jin Kim
    • 2
  • Jeong Yeon Kim
    • 1
  • Sung Gil Park
    • 1
  • Jun Ho Park
    • 2
  1. 1.Department of Surgery, Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseong-SiRepublic of Korea
  2. 2.Department of SurgeryKangdong Sacred Heart Hospital, Hallym University College of MedicineSeoulRepublic of Korea

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