Cholangioscope-assisted endoscopic retrograde appendicitis therapy for pediatric acute uncomplicated appendicitis

This study aims to investigate the safety and efficacy of the cholangioscope-assisted endoscopic retrograde appendicitis therapy in the treatment and diagnosis of pediatric acute uncomplicated appendicitis, clarify the clinical application value of this surgical approach and to compare the differences between the recurrence and non-recurrence groups postoperatively.

This study retrospectively collected and evaluated clinical data from 50 pediatric patients diagnosed with acute uncomplicated appendicitis admitted to the Second Department of General Surgery at Shenzhen Children's Hospital between November 2024 and April 2025. All patients underwent cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT). During the study, the demographic characteristics, clinical manifestations, laboratory test results, cholangioscope manifestations, treatment success rate, incidence of appendicitis recurrence and average hospital stay of the patients were systematically recorded and analyzed. Follow-up was conducted for the discharged patients.

Among the 50 included children, 47 children (94%) were successfully treated. The average postoperative follow-up time was 7.8 months (95%CI 7.2-8.3), and the average operation time was 79.20 min (95%CI 66.60-91.81). During the follow-up period, six pediatric patients were diagnosed with recurrent appendicitis by ultrasonography and subsequently underwent surgical appendectomy.The average hospital stay was 3.96 days (95%CI 3.76-4.20). Significant differences existed between the groups with and without recurrence in terms of postoperative 12-hour liquid diet tolerance and endoscopic appendiceal lumen stenosis (P < 0.05).

Cholangioscope-assisted endoscopic retrograde appendicitis therapy can be used as a surgical method for the treatment of pediatric acute uncomplicated appendicitis. Both early postoperative liquid diet tolerance and endoscopic appendiceal lumen stenosis may be related to appendicitis recurrence.