In uncomplicated appendicitis, is surgery the treatment of choice, or can you manage this conservatively with a non-operative approach and antibiotics? This has been an unanswered question throughout the whole of Archivist’s 40-year career! Most recently, there appears to be observational data to suggest that the conservative approach may well be effective and safe. This question has now been answered. This incredible study, known as the APPY study, conducted by St Peter SD et al (Lancet 2025;405: 233–240. DOI: 10.1016 /S0140-6736(24 )02420-6) was completed without funding. The Archivist feels this is one of the most important randomised controlled …