急性阑尾炎是急腹症的常见病因之一，目前临床上主要的治疗方案仍然是阑尾切除术。随着免疫学研究的进展，人们逐渐认识到肠道黏膜免疫屏障和肠道益生菌在保卫人体健康过程中发挥巨大作用。在深入研究后，免疫学家们提出阑尾并不是废用器官，它和扁桃体一样，在人体免疫过程中，发挥重要作用，因此，我们不能随意切除。随着内镜技术的发展，许多疾病已经可以通过内镜微创技术而治愈，例如急性梗阻化脓性胆管炎，以往的治疗方案是外科手术治疗，但是死亡率很高；ERCP技术问世后，死亡率下降至0.5%以下，目前，临床上已经很少通过外科手术治疗急性梗阻化脓性胆管炎。我们在2012年提出内镜逆行治疗阑尾炎（ERAT）概念并成功治疗急性阑尾炎，目前已能够治疗各种类型的急性阑尾炎，包括阑尾周围脓肿。本文的目的是通过简述阑尾炎治疗的发展，探讨另一种治疗理念和思维，为急性阑尾炎的治疗方案提供另一种新的选择。

Acute appendicitis is one of the most common reason for acute abdominal pain. The main treatment method of acute appendicitis is appendectomy. With the progress of immunology, the crucial and pivotal status of intestinal mucosal immunity and intestinal flora in protecting body against pathogens emerges. Moreover, these immunologists proposed that appendix plays a vital role in intestinal mucosal immunity. Thereby, appendix should not be removed arbitrarily.With the improvement of endoscopic techniques, many disease can be treated with the minimal invasive method. For example, the ERCP techniques enable the mortality of acute cholangitis to decrease to 0.5 percent or below. Recently, more and more surgeons treated these patients with ERCP techniques. We proposed to the concept of endoscopic retrograde appendicitis therapy (ERAT) and treated successfully the patients with acute appendicitis in 2012. At present, the technique can be adapted for all types of acute appendicitis including peri-appendiceal abscess. The aim of this article is to discuss the develop history of treatment method for the patients with acute appendicitis and provide the physicians with another new concept and method for the treatment of the patients.