Open versus laparoscopic cholecystectomy in acute cholecystitis

Abstract

Introduction: Gallstone disease (GSD or Cholelithiasis) is a significant health problem both worlds over (in both developing and developed nations). Earlier open cholecystectomy was the gold standard for treatment of stones in the gall bladder. The classical open cholecystectomy (OC) and the minimally invasive laparoscopic cholecystectomy (LC) are two alternative operations for removal of the gallbladder. Material and Methods: This study included a total of 90 patients of 20-80 years of age with sonographycally detected symptomatic gallstones. The present study was conducted on above patients admitted in the surgical wards of Kalinga Institute of Medical Sciences, from September 2018 to August 2020 and who underwent laparoscopic cholecystectomy (LC) or open cholecystectomy (OC) for their condition. Results: Duration of the operation time ranged from 50-135 min in Laparoscopic cholecystectomy (Mean±SD 87.32±7.3) and 35 to 90 min (Mean±SD: 56.2±5.7) in Open cholecystectomy. There was<100 ml blood loss in 88.8% of Laparoscopic cholecystectomy; however, in Open cholecystectomy, 91.1% had blood loss ≥100 ml. Mean duration of post-operative pain was 17.48±3.4 hours in Laparoscopic cholecystectomy and 30.54±3.45 hours in Open cholecystectomy. (p<0.001). The mean duration of hospital stays 2.03±0.12 days in Laparoscopic cholecystectomy and 5.23±0.57 days in Open cholecystectomy (p <0.001).Conclusion: Laparoscopic cholecystectomy is an easy to perform, less time-consuming procedure, with low complication rates as compared to open cholecystectomy. It also gives an advantage of a shorter hospital stay and early return to work as compared to the open cholecystectomy. Hence laparoscopic cholecystectomy as a surgical procedure to remove gall bladder can be recommended over open cholecystectomy operation in carefully selected patients of symptomatic gall stone disease.