Background: An appendectomy is the surgical removal of the appendix. Appendectomy may be performed laparoscopically or as an open operation. Laparoscopy is now often used as patient resumed normal activity within a shorter period than had been experienced with open appendectomy. Patients had a superior cosmetic result and experienced significantly less postoperative discomfort. In this study, we attempted to determine the predictors for difficult appendectomy using history and clinical examinations, preoperative laboratory data, ultrasonography findings and intraoperative finding.Methods: The study was conducted in Sarojini Naidu Medical College, Agra. All patients who underwent laparoscopic appendectomy from 1st January 2016 to 30th June 2017 were included in the study. A detailed performa was developed to record information regarding patient history, physical examination, laboratory parameters, ultrasonography (USG) findings and intra-operative details. Laparoscopic appendectomy done in more than 120 minutes, converted into open due to difficulty in surgery and not due to complications, severe adhesions were considered to be a case of difficult appendectomy.Results: We found that the difficult laparoscopic appendectomy can be predicted preoperatively based on age >60 years, history of previous lower abdominal surgery, time of onset to surgery >24 hours, acute appendicitis and peri appendicular collection.Conclusions: There are very few reports to determine the predictors of difficult appendectomy and more research is required to establish it.

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