According to retrospective studies the conservative management of periappendicular abscess is associated with decreased complication and re-operation rate compared with open appendectomy. Large abscesses require percutaneous drainage. Sometimes percutaneous drainage is not possible because of anatomical position of the abscess and surgical treatment is needed. The purpose of this study is evaluate whether laparoscopic appendectomy is suitable for the first-line treatment in patients with periappendicular abscess.

The hypothesis of the study is that laparoscopic management of periappendicular abscess is suitable for the first-line treatment and it does not increase time of hospitalization or complication rate compared with conservative management.

Inclusion Criteria:

• Periappendicular abscess at least 2 cm in size

Exclusion Criteria:

• Missing written informed consent
• Antimicrobial therapy lasted over 24 hours before randomization
• Attempt of drainage before randomization
• Age over 80 years or under 18 years old
• Pregnancy
• Allergy to either Cefuroxime or Metronidazole
• Severe chronic disease, that substantially increases the risk for operative mortality
• Previous major intra-abdominal surgery, that may have caused intra-abdominal adhesions
• Carrier of a resistant bacterial strain
• Being institutionalized or hospitalized for at least 2 weeks before randomization