Laparoscopic appendectomy in children: a systematic review. A systematic review was undertaken to examine the available literature concerning the safety and efficacy of laparoscopic appendectomy (LA) in children. Twelve reports of laparoscopic appendectomy (LA) in pediatric patients (age < 18 years) were identified. LA was performed with insufflation or without insufflation. Results for operating time, blood loss, complications, length of hospital stay, wound infection, and return of bowel function were extracted. There were only five comparative studies; four of them were case-matched case studies. Of the remaining seven studies, no data were provided. The average age was 8.5 years; patients ranged from 1 to 17 years. Conversion to open appendectomy occurred in 0% to 2.8% of cases. Laparoscopy was successful in 9 of 12 patients. The mean operating time was 73 minutes (range 31 to 215 minutes), and the mean length of hospital stay was 1 day (range 0 to 3.5 days). There was one conversion to open appendectomy. One (9%) of the patients required intravenous analgesia postoperatively, while the remaining 11 patients (91%) required no analgesics and had bowel functions within 24 hours of surgery. The only complication was one case of postoperative ileus (8%). No wound infections occurred, and all wounds healed by first intention. The available data for LA in children are limited. However, the available data indicate that LA is an acceptable alternative for appendectomy in children and, therefore, should be considered in patients who are potential candidates for LA. Further studies of LA in pediatric patients are indicated.