Clinical Study of Complications of Laparoscopic Cholecystectomy and Open Cholecystectomy

Abstract

This is clinical study of 440 patients undergoing elective laparoscopic and open cholecystectomy in a tertiary care hospital during the period from June 2013 to June 2016. Out of the 440 patients, 50% underwent laparoscopic surgery and 50% open cholecystectomy. The incidence of gall bladder disease was highest in the age group of 41-50 years, showing incidence of 33 %. The mean age incidence in present study was 44.71 years. Incidence of Complication was also highest in age group 41-50 yrs. Majority patients were females, which were found to be 282 patients, while male were 158 patients. Ratio of male to female was 1: 1.78. Complication rate in male and female was 10.12% and 9.21% respectively. Male and females had no significant statistical difference for the incidence of complications in both Laparoscopic and open cholecystectomy groups. Pre operative ultrasonographic finding of gall bladder wall thickness > 3mm was associated with an increased risk of complication and conversion of laparoscopic cholecystectomy to open cholecystectomy. Obesity [BMI > 30 kg/m2] and acute cholecystitis was associated with increased risk of complication as well as conversion. The mean operating time increased in the cases which complicated intraoperatively. Complication rate among both groups in Laparoscopic and open cholecystectomy was 8.18 % and 10.9% respectively. Thus there was no significant difference in the incidence of complications. Spillage of gall stone was most common complication in laparoscopic cholecystectomy followed by intraoperative gall bladder perforation and biliary duct injury. Whereas following open cholecystectomy, post operative wound infection was the most common complication, followed by post operative bile leakage. Complication rate among both study groups was similar but, intra operative morbidity and severity of complications was more in laparoscopic cholecystectomy.