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The Cost-Effectiveness of Conservatively Managed Acute Appendicitis Versus Appendicectomy: A Systematic Review
Imran Farhad1, Muhammad A Khan1, Aaron Kler2
1School of Medicine.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|March 25, 2026
Summary
Conservative management of acute appendicitis is more cost-effective than surgery. This finding is crucial for healthcare systems with limited resources, though further research is needed.
Area of Science:
- Health Economics
- Surgical Outcomes
- Public Health
Background:
- Appendicectomy is the standard treatment for acute appendicitis.
- Debate exists regarding the clinical benefits of conservative management for acute appendicitis.
- Cost-effectiveness of surgical versus conservative treatment is a critical factor.
Purpose of the Study:
- To evaluate the health economic evidence comparing appendectomy and conservative management for acute appendicitis.
- To determine the most economically viable treatment option for acute appendicitis.
Main Methods:
- Systematic literature search of 3 databases following PRISMA standards.
- Prospective registration of study protocol with PROSPERO (ID: CRD42023412691).
Main Results:
- Included 5 studies with 1219 patients (639 surgery, 580 conservative).
- Surgery was significantly more expensive than conservative treatment (16.5%–83.0% cost difference).
- Hospitalization length was similar; 12-month follow-up in most studies; considerable risk of bias identified (CHEERS).
Conclusions:
- Conservative management is the more economically effective treatment for acute appendicitis.
- This approach is particularly relevant for resource-limited healthcare systems.
- Further standardized research with longer follow-up is needed to confirm economic and clinical effectiveness.
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