Background To evaluate the clinical efficacy and safety of endoscopic retrograde appendicitis treatment with cholangioscope assistance (ERAT) in the treatment of acute non-complex appendicitis.

Methods A retrospective analysis was conducted on the medical records of 20 patients with acute non-complex appendicitis who underwent ERAT from March 2023 to March 2024 in our hospital, designated as the study group. This method employs direct visualization technology of the cholangioscope combined with endoscopic retrograde appendiceal intubation for appendiceal cavity irrigation, decompression, and foreign body removal when necessary. Additionally, 20 cases of acute non-complex appendicitis patients who underwent standard laparoscopic appendectomy during the same period were set as the control group. The therapeutic effects and related treatment indicators between the groups were compared.

Results The study revealed that the ERAT group demonstrated remarkable performance in reducing postoperative pain perception, shortening hospital stay, and enhancing early quality of life, with a high surgical success rate of 95%. Compared to laparoscopic appendectomy, ERAT showed good feasibility and safety. Furthermore, patients in the ERAT group reported higher satisfaction with the treatment, highlighting the advantages of this therapy in preserving anatomical integrity and minimizing trauma. However, a minority of cases (1/20, 5%) required conversion to conventional surgery due to technical difficulties or disease progression.

Conclusions Endoscopic retrograde appendicitis treatment with cholangioscope assistance offers an effective minimally invasive treatment option for patients with acute non-complex appendicitis, particularly suitable for those seeking to preserve appendicular function and reduce surgical trauma. However, its application necessitates a strict selection of indications and should be performed by experienced endoscopists.