Comparative study between laparoscopic and open cholecystectomy (Study of 50 cases)

Abstract

Background: Laparoscopic cholecystectomy is a new alternative to the traditional open approach for treating calculous cholecystitis. It is therefore necessary to assess the efficacy of laparoscopic cholecystectomy over the open cholecystectomy. Objectives: To compare the surgical outcomes of laparoscopic cholecystectomy with those of open cholecystectomy. Materials and methods: 50 patients diagnosed as symptomatic cholelithiasis proven by radiological investigations were distributed into two groups of 25 each. Group A patients were subjected to laparoscopic cholecystectomy and group B patients underwent open cholecystectomy. The surgical outcomes were studied prospectively. Intraoperative complications and post-operative care parameters were evaluated. Results: Mean age of patients in group A was 46.68±13.6 years and in group B was 42.64±14.1 years. Majority of patients were in age group of 41 to 60 years. Patients who were diabetic in the group B developed wound infections whereas diabetic patients in the group A did not develop any infection. Significant bleeding necessitating blood transfusion occurred in one patient belonging to the group B. The duration of post-operative analgesia required was 3.16 days in group A and 5.16 days in group B. The duration of post-operative antibiotics administered in laparoscopic and open cases was 1.48 and 4.8 days respectively. One of the patients in group A developed post-operative biliary leak whereas none in group B had any such complication. The commencement of oral feeds and thereafter return of bowel movements was earlier in group A as compared to group B. The mean hospital stay was 4.5 days in group A as compared to 6.3 days in group B. Conclusion: Laparoscopic cholecystectomy is superior to open cholecystectomy with regards to reduced post-operative discomfort and pain, antibiotic and analgesic requirement, early commencement of oral feeds, and shorter duration of hospitalization.