A Comparative Study of Open Cholecystectomy versus Laparoscopic Cholecystectomy- A Hospital Based Study (original) (raw)
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COMPARATIVE STUDY BETWEEN LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY (STUDY OF 50 CASES
International Journal of Medical Reviews and Case Reports, 2021
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 cholecys-tectomy, and group B patients underwent open cholecystectomy. The surgical outcomes were studied prospectively. Intraoperative complications and postoperative care parameters were evaluated. Results: Mean age of patients in group A was 46.68±13.6 years, and in the group, B was 42.64±14.1 years. Majority of patients were in the age group of 41 to 60 years. Patients who had diabetes in group B developed wound infections, whereas diabetic patients in group A did not develop any infection. Significant bleeding necessitating blood transfusion occurred in one patient belonging to group B. The duration of postoperative analgesia required was 3.16 days in group A and 5.16 days in group B. The duration of postoperative antibiotics administered in laparoscopic and open cases was 1.48 and 4.8 days, respectively. One of the patients in group A developed a postoperative biliary leak, whereas none in group B had any such complication. The commencement of oral feeds and after that return of bowel movements was earlier in group A than 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 regarding reduced postoperative discomfort and pain, antibiotic and analgesic requirement, early commencement of oral feeds, and shorter duration of hospitalization.
Laparoscopic and open cholecystectomy: A comparative study
International Journal of Surgery Science, 2020
Background: Gallstone (GS) disease is a major health problem worldwide particularly in the adult population. Gallstones are a common occurrence in northern India. Prevalence of gallstone ranges from 10 to 20% in India. 2 It affects nearly 4. 3% of the population. Subjects and Methods: 146 Patients of cholelithiasis aged between 16 years to 65 years operated during the period from July 2017 to December 2019. They were divided into open and laparoscopic Cholecystectomy group. The patients were studied with respect to their clinical presentation and were categorized as patients with asymptomatic Gall stones, acute calculus cholecystitis and chronic calculus cholecystitis. Results: In open cholecystectomy group 45% were males and 55% females. In laparoscopic cholecystectomy group 36% were males and 64% females. The age range was from 16-65 year in both the groups. The mean age was 36. 29±14. 60 years for group open cholecystectomy and 34. 47±11. 20 years for group laparoscopic cholecystectomy. Symptoms of patients in both the groups were almost same. The mean operation time for Laparoscopic cholecystectomy was significantly longer than for Open cholecystectomy. Conclusion: The laparoscopic cholecystectomy is a safe and effective treatment of complicated gallstone disease. Laparoscopic cholecystectomy is better than open cholecystectomy in terms of post-operative pain, analgesic requirement and early return to work.
Comparison of Laparoscopic Cholecystectomy versus Elective Open Cholecystectomy
Journal of Laparoendoscopic Surgery, 1992
Laparoscopic cholecystectomy has essentially replaced open cholecystectomy as the procedure of choice for gallbladder disease. This rapid shift to laparoscopic cholecystectomy, however, has resulted more from marketing forces than from prospective clinical trials. To evaluate the safety and efficacy of laparoscopic cholecystectomy, the first 486 laparoscopic cholecystectomies at two institutions were studied. These results were then compared to the results of the last 6 months of elective open cholecystectomy cases prior to the introduction of laparoscopic surgery. The age, sex, height, and weight were similar in both groups. The mean operative time was 78.8 ±1.8 min for laparoscopic cholecystectomy and 62.7 ± 2.6 min for open cholecystectomy (p < 0.01). The mean time for tolerating a regular diet was 1.23 ± 0.04 days in the laparoscopic group versus 2.44 ± 0.07 days in the open group (p < 0.01). Laparoscopic cholecystectomy patients required only oral pain medications by a mean of 1.22 ± 0.03 days postoperatively compared to 2.55 ± 0.07 days postoperatively for those undergoing open cholecystectomy (/; < 0.01). The mean length of hospitalization was 1.58 ± 0.07 days for laparoscopic patients and 3.55 ± 0.11 days for open patients (p < 0.01). Thirty-one patients undergoing laparoscopic cholecystectomy were converted to open cholecystectomy (6.4%). The most common reasons for conversion to open cholecystectomy were acute inflammation, adhesions, and bleeding. For the laparoscopic patients, the morbidity rate was 8.4% and the mortality rate 0.2% (1 death). In the open cholecystectomy group the morbidity rate was 8.0% and there were no deaths. The most troublesome complication in laparoscopic cholecystectomies continues to be bile leaks and bile duct injuries. The authors report two cases of bile duct injuries and one case of bile leak which resulted in the one death in the study. This study reveals some clear advantages of laparoscopic cholecystectomy. However, laparoscopic cholecystectomy remains a major operation with potential for serious morbidity and even death.
Comparative Study of Laparoscopic Cholecystectomy with Open Cholecystectomy
Journal of Evolution of Medical and Dental Sciences, 2014
After the first laparoscopic cholecystectomy performed in 1988 by Dubois and Perissat, it soon became the gold standard for cholelithiasis and has evolved like a revolution in surgical field in recent times. This study was conducted to study and compare laparoscopic cholecystectomy with open cholecystectomy in terms of operative time, post-operative pain, post-operative analgesic requirement, post-operative oral intake resumption, time required for ambulation of patient, duration of hospital stay and complications and conversion rate. This was an observational comparative study and results were compared using Z Test of significance. All cases of symptomatic gall stones were included in this study. Of 159 cholecystectomy patients 124 patients had laparoscopic cholecystectomy of which 6 patients had to be converted to open cholecystectomy and 35 patients underwent open cholecystectomy. Main outcome measures were Operating time, Pain severity, Analgesic requirement, Time of resumption of oral feeds, Time of ambulation , Length of hospital stay, Rate of conversion from LC to OC, and Complications. After studying all these outcome measures we reached to a conclusion that Laparoscopic cholecystectomy is a safe, valid alternative to OC in patients with symptomatic cholelithiasis. The technique has a low rate of complications, implies a shorter hospital stay, and offers the patient a more comfortable postoperative period than OC.
An Audit of Laparoscopic Cholecystectomy
Objective: To evaluate the morbidity and mortality rates in laparoscopic cholecystectomy. Material and Methods: This retrospective descriptive study was carried out in surgical "D" ward Khyber Teaching Hospital, Peshawar, from December 2012 to December 2014 in which 233 patients after fulfilling the inclusion and exclusion criteria with symptomatic gallstones disease were enrolled. Demographics, complications of surgery and conversion to open were reviewed from clinical notes and noted on a pre-designed proforma. Data were analyzed using SPSS version 16 and results compared with other studies. Results: A total of 233 patients were studied during the audit period. Of these 41(17.6%) were males and 192(82.4%) were females. Mean age of patients was 36.56±11.32 years. Mean operating time was 56.57±13.95 minutes. Complications encountered during the study include conversion to open cholecystectomy 2 (0.9%), epigastric port site bleeding 3 (1.3%) and port site infection 6(2.5%). Mean hospital stay was 3.37±2.27 days. There were no cases of umbilical port hernia, bile duct or colonic injury. No mortality was observed in our study. Conclusion: The various data collected during the audit suggest that the results of laparoscopic cholecystectomy carried in our unit are satisfactory.
The Clinical Outcome of Traditional Laparoscopic Cholecystectomy
Gaziantep Medical Journal, 2013
Laparoscopic cholecystectomy is a safety, efficacy,established method for the treatment of symptomatic gallstone disease. We aim to share traditional laparoscopic cholesistectomy experience and complications that treated with experienced surgeons in low-volume hospitals. This study was performed during the period of 2009-2011 in three hospital. We analyzed retrospectively 266 patients, who were operated elective by three surgeon whose experiences were closely. We compared demographic data, patients age, gender, number of ports, operation time, length of hospital stay, whether or not previous abdominal surgery, whether or not systemic disease, whether or not has been performed ERCP, reason of converted from laparoscopic to open cholecystectomy and complications. 266 [165 (%72,6) female and 101 (%27,4) male] patients evaluated retrospectively. The average age was 42,6 (range 27-42). The average duration of operation was 45 minutes (range 35-72). The operation was performed by using four ports in 195 (73,3%) patients and by using three ports in 71 (26,7%) patients. 25 (9,4%) patients had intra-abdominal drainage. ERCP was performed preoperatively in 5 (9,4%) patients. We convert open cholecystectomy in6 (2,3%) patients, due to bleeding, in 4 patients (1,5%) due to anatomical mismatch, 3 patients (1,1%) due to adhesions and difficult technical conditions. Laparoscopic cholecystectomy can be performed seamlessly with appropriate patient selection in low-volume hospitals, We believe that multidisciplinary approach was a priority in case with complications, it will be useful in terms of patient morbidity and mortality.
The Effects of Laparoscopic Cholecystectomy a Cross-Sectional Study
Zenodo (CERN European Organization for Nuclear Research), 2022
This paper aims to know the type of effects after laparoscopic cholecystectomy. The behaviour of surgical treatment of gallbladder diseases was determined by laparoscopic cholecystectomy. A cross-sectional study was conducted in different hospitals in Iraq, and all patients who were exposed to gallbladder disease were tributaries of surgical treatment from February 2019 to April 2020; and in this study, 110 were collected and divided into two groups (single incision laparoscopic cholecystectomy 50 patients) (conventional laparoscopic cholecystectomy 60 patients). The main risk factors for laparoscopy in our study were those related to the origin of ischemic heart disease with a total of 35 patients (31.8%) in both groups, heart valve disease and Arrhythmia in both groups for 22 patients with (20%). The Laparoscopic Cholecystectomy Visual Rating Scale has been relied on for the purpose of Data about pain and nausea-vomiting. The results showed a high severity for patients who underwent single incision laparoscopic cholecystectomy at all levels and a higher death rate for four patients compared with two patients for conventional laparoscopic cholecystectomy. We conclude from this study that conventional laparoscopic cholecystectomy is currently considered the gold standard for the purpose of obtaining fewer complications as conventional laparoscopic cholecysectomy, and it is the preferred method for doctors to laparoscopic cholecystectomy.
[Comparison of open and laparoscopic cholecystectomy in the treatment of acute cholecystitis]
PubMed, 2005
The paper analyses and compares the results of the treatment of acute cholecystitis with open and laparoscopic approach in a seven-year period. From 1994 to 2000, 311 patients with clinical picture of acute cholecystitis were operated. Open cholecystectomy was done in 162 (52.09%) patients, and laparoscopy in 149 (47.91%). In both patient groups the time from the onset of clinical symptoms to the surgery, and preoperative workup and preparation, were the same. In patients with open surgery the procedure lasted 93 (+/-SD) minutes, and in those with laparoscopic surgery 114 (+/-SD) minutes. Those operated with open method received 5.83 (+/-SD) ampules and 3.75 (+/-SD) tablets of analgesics, and those with laparoscopic surgery 3.2 (+/-SD) ampules and 2.1 (+/-SD) tablets per patient. Antibiotics were administered to 149 patients with open surgery for 4.9 (+/-SD) days and to 68 of those with laparoscopic surgery for 2.29 (+/-SD) days. Patients with open surgery stayed in the hospital 9.55 (+/-SD) days and were on sick leave 43 (+/-SD) days, and those with laparoscopy spent 4.35 (+/-SD) days in hospital and were 16 (+/-SD) days on sick leave. In conclusion, better clinical results and faster return to everyday activities point to the significant advantage of laparoscopic cholecystectomy. Analysis of the results shows that total costs of treatment of working patients are significantly lower than of those with laparoscopic surgery, due to shorter hospital stay, shorter sick leave, and faster recovery.
Pakistan Armed Forces Medical Journal, 2016
Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (OC) in 450 patients who underwent laparoscopic cholecystectomy (LC) by the same surgeon in tertiary care teaching hospitals. Study Design: Descriptive study. Place and Duration of Study: The study was conducted initially at Pakistan Navalship (PNS) Shifa, Karachi and later at Combined Military Hospital, Lahore from November 2009 to June 2013. Material and Methods: All the patients of both genders and of any age group, undergoing LC for gall bladder pathology whether acute or chronic, acalculous or calculous were included in this study by convenient sampling. The exclusion criteria were choledocholithiasis, malignancy, and patients who willingly opted for open cholecystectomy. All the patients were operated by the same experienced laparoscopic surgeon. The number and sizes of the ports varied from patient to patient and was on the choice of the operating surgeon. A detailed proforma was fi...