Comparative Analysis of Early Clinical Outcomes in Patients Experience Open vs. Laparoscopic Cholecystectomy

Abstract

Background:Laparoscopic cholecystectomy (LC) has largely replaced open cholecystectomy (OC) for acute cholecystitis due to its minimally invasive nature. However, the impact of surgical timing (early vs. delayed) and outcomes in elderly patients remains unclear. Objective:To compare clinical safety, complications, and recovery outcomes of LC and OC, with a focus on age-related differences and surgical timing. Methods:A prospective cross-sectional study was conducted on 500 patients with acute cholecystitis. Patients were stratified into LC (n=300) and OC (n=200) groups. Subgroup analysis was performed for younger (<60 years) and elderly (≥60 years) patients, as well as early (<7 days) and delayed (>6 weeks) LC. Key outcomes included hospital stay duration, complications (wound infections, bile duct injury), and biomarker changes (CRP, WBC). Data were analyzed using SPSS v29.0, with p<0.05 considered significant. Results:LC resulted in shorter hospital stays (3.2 ± 1.5 days vs. 8.4 ± 2.0 days; p<0.001) and fewer wound infections (5.6% vs. 13.5%; p=0.008) compared to OC. Conversion to OC occurred in 10.3% of LC cases due to severe adhesions. Elderly patients had higher complication rates (19.8% vs. 8.4%; p=0.012). Early LC showed fewer complications (8.4% vs. 16.2%; p=0.002) and faster inflammatory resolution (CRP reduction; p<0.001). Conclusion:LC is superior to OC in terms of recovery and safety, particularly with early intervention. Elderly patients require careful evaluation of comorbidities to minimize complications.