Comparison in Terms of Postoperative Morbidity and Hospital Stay between Open Cholecystectomy and Laparoscopic Cholecystectomy

Abstract

Type of study: Comparative. Aim: To compare the postoperative morbidity in terms of postoperative pain, gait disturbances, wound and respiratory infections along with length of hospital stay in patients undergoing laparoscopic cholecystectomy with those undergoing open surgery for symptomatic gallstone disease to compare the effectivity of minimally invasive surgery with open surgery in reducing postoperative morbidity and thus length of hospital stay. Place and duration of study: Surgical Unit Khyber Teaching Hospital, Peshawar, Pakistan; from July 2006 to December 2006. Materials and methods: This study included a total of 50 patients who underwent either open or laparoscopic cholecystectomy in our unit (SDW KTH). Their clinical data, admission dates and date of surgery were noted. Postoperative progress was followed and requirement of analgesia, nausea, vomiting, febrile morbidity, wound infections and respiratory tract infections, if any were noted. Their date of discharge from hospital was also recorded. Re-admission (if any) for any complication of surgery was noted and further days spent in hospital were recorded. This data was analyzed to see the post-operative morbidity and length of hospital stay in these patients. Results: Out of the 50 patients included in this study, the mean hospital stay for the patients who underwent laparoscopic cholecystectomy was 2.06 days as against 3.93 days for those having open surgery for symptomatic gallstone disease. Also pain (and thus analgesia requirement) and other complications were significantly lower for the patients who had minimally invasive surgery indicating the superiority of laparoscopic technique as regards postoperative hospital stay and morbidity. Conclusion: Minimally invasive surgery is infact very effective in reducing postoperative morbidity and thus hospital stay in patients with gallstones. Although open cholecystectomy is still performed in our hospitals, the time is near when it will be largely replaced by the laparoscopic technique.