Abstract
A Acute appendicitis (AA) remains one of the most frequent abdominal emergencies worldwide, necessitating precise diagnosis and timely intervention to prevent complications. This study aimed to explore the main clinical approaches to the management of complicated and uncomplicated acute appendicitis, evaluating conservative antibiotic therapy, laparoscopic appendectomy (LA), and open appendectomy (OA). A literature-based review was conducted using recent studies on diagnostic criteria, treatment outcomes, and surgical decision-making. Conservative treatment was shown to be effective in selected cases of uncomplicated appendicitis, particularly in patients with high surgical risk, although with higher recurrence rates. Laparoscopic appendectomy demonstrated clinical advantages such as reduced hospital stay, lower surgical site infection rates, and faster recovery, but was associated with a higher risk of intra-abdominal abscesses in complicated cases. Open surgery remains the gold standard for patients with diffuse peritonitis, hemodynamic instability, or widespread infection. The experience of the surgical team, patient comorbidities, and timing of diagnosis were identified as crucial factors in outcomes. In conclusion, the choice of treatment should be individualized, balancing risks, benefits, and available resources. The integration of evidence-based protocols and clinical judgment is essential for optimizing patient recovery and minimizing complications;