Single-use cholangioscope-assisted endoscopic management of appendicitis

Background Appendicitis is a common global surgical emergency. While traditional appendectomy remains effective, it carries risks of complications and negative appendectomy. Endoscopic Retrograde Appendicitis Therapy (ERAT), a minimally invasive technique, achieves therapeutic effects through appendicolith extraction, pus drainage, and stent placement to lower intraluminal pressure, which helps manage both acute and chronic appendicitis. Objective To investigate the value of the single-use cholangioscope (the eyeMax subscope) in the endoscopic management of appendicitis. Methods We enrolled 33 patients diagnosed with acute uncomplicated appendicitis and chronic appendicitis between June 2024 and January 2025. The diagnosis was confirmed by computed tomography (CT) or ultrasound and verified by colonoscopy and single-use cholangioscope. We collected and analyzed demographics, colonoscopy findings, subscope findings, and recorded surgical success rates, duration, hospital stays, clinical outcomes, and adverse reactions after endoscopic retrograde appendicitis therapy (ERAT). Results All 33 patients were diagnosed with acute uncomplicated simple appendicitis or chronic appendicitis. We achieved successful appendiceal intubation in 31 patients (93.94%). One 14-year-old patient with hemophilia A had acute appendicitis. After ERAT, the patient felt relief from abdominal pain and had no postoperative complications. Four patients(12.12%) with chronic abdominal pain achieved successful symptom resolution post-treatment. Five patients (15.15%) received concurrent endoscopic colorectal polypectomy during the procedure. The mean operative time was 48.61 ± 23.36 minutes, with an average postoperative hospital stay of 2.42 ± 1.12 days. During 1–8 months of follow-up, 2 patients (6.06%) required surgical intervention for recurrent appendicitis. Conclusion Single-use cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT) is a safe and effective option for diagnosing and treating appendicitis.