Comparative Study of Postoperative Outcomes in Laparoscopic Versus Open Cholecystectomy in Patients with Acute Cholecystitis
DOI:
https://doi.org/10.53350/pjmhs02026206.3Keywords:
Acute cholecystitis, laparoscopic cholecystectomy, open cholecystectomy, postoperative outcomes, comparative study.Abstract
Background: Acute cholecystitis is frequent surgical emergency whose treatment is conclusive with respect to cholecystectomy. Even though laparoscopic cholecystectomy has become the treatment of choice to treat gallbladder disease, it is still a controversial practice in the treatment of acute cholecystitis especially in areas, where it is not available. The aim of this research was to compare the following postoperative outcomes of laparoscopic and open cholecystectomy in patients with acute cholecystitis.
Methods: This is a prospective comparative study, which was carried out at the Department of General Surgery, POF Hospital Wah Cantt, between January 2025 and December 2025. There were 150 adult patients with acute cholecystitis who were assigned to the two groups of laparoscopic cholecystectomy (n=78) and open cholecystectomy (n=72). Information on operative time, postoperative pain (VAS score), ambulation, oral intake, length of stay, postoperative complications, and 30-day readmission were gathered and analyzed in SPSS version 25. A p-value less than 0.05 was deemed to be significant statistically.
Findings: The mean time of operation was less by far in the laparoscopic group than in the open group (72.3 ± 15.5 vs 95.8 ± 18.2 minutes; p<0.001). Laparoscopic cholecystectomy was correlated with much lower postoperative pain scores, earlier ambulation, earlier resume oral intake and shorter hospital stay (p<0.001). Any overall postoperative complications were less in the laparoscopic group (10.3% vs. 27.8% in the open group, p=0.005) and surgical site infection more frequent following the open cholecystectomy. In both groups no postoperative mortality was seen.
Conclusion: Laparoscopic cholecystectomy has proven to be a safe and effective intervention in the treatment of acute cholecystitis and is considered to have a better result in terms of postoperative effects than open cholecystectomy. Its daily application ought to be promoted in due-selected patients including acute care to enhance recovery and minimise morbidity postoperative.
References
Strasberg SM. Acute calculous cholecystitis. N Engl J Med. 2008;358:2804–2811.
Shaffer EA. Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20(6):981–996.
Yokoe M, et al. Diagnostic criteria and severity assessment of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20:35–46.
Glenn F. Cholecystectomy: a review of 15,000 cases. Ann Surg. 1981;193(4):382–388.
Reynolds W Jr. The first laparoscopic cholecystectomy. JSLS. 2001;5(1):89–94.
Strasberg SM, Brunt LM. Rationale and use of the critical view of safety. J Am Coll Surg. 2010;211(1):132–138.
Gurusamy KS, et al. Early versus delayed laparoscopic cholecystectomy. Cochrane Database Syst Rev. 2013;6:CD005440.
Johansson M, et al. Management of acute cholecystitis: laparoscopic vs open surgery. World J Surg. 2003;27:353–358.
Khan JS, et al. Frequency of gallstones in Pakistan. J Ayub Med Coll Abbottabad. 2010;22(4):46–48.
Livingston EH, Rege RV. A nationwide study of conversion rates. Am J Surg. 2004;188:205–211.
Bisgaard T. Analgesic treatment after laparoscopic cholecystectomy. Br J Surg. 2006;93:771–778.
Keus F, et al. Laparoscopic vs open cholecystectomy. Cochrane Database Syst Rev. 2006;4:CD006231.
Richards C, et al. Surgical site infections after cholecystectomy. Clin Infect Dis. 2003;36(2):139–145.
Tokyo Guidelines 2018. Management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018;25:55–72.
Shea JA, et al. Mortality and complications associated with laparoscopic cholecystectomy. Ann Surg. 1996;224(5):609–620.
Törnqvist B, et al. Effect of intended laparoscopic cholecystectomy on outcomes. Ann Surg. 2015;261(5):940–947.
Giger UF, et al. Risk factors for bile duct injury. Br J Surg. 2006;93(9):1109–1115.
Pessaux P, et al. Laparoscopic cholecystectomy in acute cholecystitis. Ann Surg. 2000;231(3):401–406.
Bisgaard T, et al. Pain after laparoscopic vs open cholecystectomy. Surg Endosc. 2001;15:826–830.
Lujan JA, et al. Laparoscopic cholecystectomy outcomes. World J Surg. 1998;22:133–136.
Keus F, et al. Meta-analysis of laparoscopic vs open cholecystectomy. Cochrane Database Syst Rev. 2010;2:CD006231.
Siddiqui NA, et al. Laparoscopic cholecystectomy in Pakistan. J Coll Physicians Surg Pak. 2008;18(3):138–141.
Mangram AJ, et al. Surgical site infection guidelines. Infect Control Hosp Epidemiol. 1999;20(4):250–278.
Strasberg SM. Biliary injury prevention. J Am Coll Surg. 2015;220(1):132–148.
Waage A, Nilsson M. Bile duct injury rates. Ann Surg. 2006;243(6):753–760.
Kama NA, et al. Predictive factors for conversion. Am J Surg. 2001;181(6):520–525.
Shea JA, et al. Complications and mortality of cholecystectomy. Ann Surg. 1996;224(5):609–620.
Barkun JS, et al. Economic impact of laparoscopic surgery. Surg Endosc. 1998;12:975–980.
Yokoe M, et al. Tokyo Guidelines 2018. J Hepatobiliary Pancreat Sci. 2018;25:55–72.
Gurusamy KS, et al. Surgical management of acute cholecystitis. BMJ. 2014;348:g624.
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