A comparative study between laparoscopic and open cholecystectomy in cases of cholecystitis with cholelithiasis: one year experience in tertiary care center
DOI:
https://doi.org/10.18203/2349-2902.isj20170446Keywords:
Calculous cholecystitis, Laparoscopic chlolecystectomy, Open cholecystectomyAbstract
Background: Gall stones are a major cause of morbidity all over the world. Until the end of 1980’s, open cholecystectomy was the gold standard for treatment of stones in the gall bladder. Laparoscopy has revolutionized surgery causing a re-evaluation of treatment strategies including cholecystectomy, however, it is not completely devoid of pitfalls. This study was undertaken to determine whether laparoscopic cholecystectomy can be recommended over open cholecystectomy as the procedure of choice for the treatment of cholecystitis with cholelithiasis.
Methods: This study included a total of 100 patients in the age group 20-70 years diagnosed as calculous cholecystitis on ultrasonography and admitted to the surgical wards of Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India between November 2014 to October 2015. They were divided into two groups. Group I (n = 50) who underwent laparoscopic cholecystectomy and Group II (n = 50) who underwent open cholecystectomy.
Results: A comparison of the two groups showed that the duration of surgery was significantly more in Group I (mean 52.32 minutes) as compared to Group II (mean 37.66 minutes) (p <0.001). There was <100 ml blood loss in the majority of Group I cases (94%), however, in Group II, majority had blood loss ≥100 ml (96%) (p <0.001). Mean duration of post-operative pain was 14.68 hours in group I and 27.92 hours in group II (p <0.001). Time taken to restoration of oral feeds, was less in group I (mean 11.68 hours) as compared to group II (mean 17.24 hours). Post-operative hospital stay was a mean of 1.18±0.52 days in Group I and a mean of 4.78±1.42 days in Group II (p<0.001). The time taken for resumption of normal activity was two days and three days (p <0.001) in group I and II respectively. In Group I, average cost of treatment was rupees 10870, but in Group II it was significantly more at rupees 12152 (p = 0.007).
Conclusions: Laparoscopic cholecystectomy as a surgical procedure can be recommended over open cholecystectomy in carefully selected patients of gall stone disease.
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References
Doke A, Gadekar N, Gadekar J, Dash N, Unawane S. A comparative study between open versus laparoscopic cholecystectomy. Sch J App Med Sci. 2016;4(1):57-61.
Sherry CK. Open Cholecystectomy. Am J Surg. 1993;165:435-9.
Starasberg SM. Clinical practice acute, calculus cholecystitis. New England Journal.2011;358(26):2804.
Choy I, Kitto S, Aryee N, Okrainec A. Barriers to the uptake of laparoscopic surgery in a lower-middle-income country. Surg Endosc. 2013;27(11):4009-15.
Lundberg O, Kristoffersson A. Open versus laparoscopic cholecystectomy for gallbladder carcinoma. J Hepatobiliary Pancreat Surg. 2001;8(6):525-9.
Pessaux P, Regenet N, Tuech JJ, Rouge C, Bergamaschi R, Arnaud JP. Laparoscopic versus open cholecystectomy: a prospective comparative study in the elderly with acute cholecystitis. Surg Laparosc Endosc Percutaneous Tech. 2001;11:252-5.
Glavic Z, Begic L, Simlesa D, Rukavina A. Treatment of cute cholecystitis a comparison of open vs. laparoscopic chlolecystectomy. Surg Endosc. 2001;15:398-401.
Sangwan MK, Sangwan V, Garg MK, Singla D, Thami G, Malik P. Gallstone disease menacing rural population in north India: a retrospective study of 576 cases in a rural hospital. Int Surg J. 2015;2(4):487-91.
Lal P, Agarwal PN, Malik VK, Chakravarti AL. A difficult laparoscopic cholecystectomy that requires conversion to open procedure can be predicted by preoperative ultrasonography. JSLS. 2002;6(1):59-63.
Otibi RF, Junied NJA. A comparison of open cholecystectomy surgical method with the laparoscopic one. International J Healthcare Sci. 2016;3(2):217-22.
Karim T, Kadyal A. A comparative study of laparoscopic vs. open cholecystectomy in a suburban teaching hospital. J Gastrointest Dig Syst. 2015;5:371.
Poggio JL, Rowland CM, Gores GJ, Nagorney DM, Donohue JH. A comparison of laparoscopic and open cholecystectomy in patients with compensated cirrhosis and symptomatic gallstone disease. Surgery. 2000;127(4):405-11.
Doke A, Gadekar N, Gadekar J, Dash N, Unawane S. A comparative study between open versus laparoscopic cholecystectomy. Sch J App Med Sci. 2016;4(1):57-61.
Anmol N, Lakshminarayan G, Manohar TM, Avadhani GK, Abinash H. Outcome following open and laparoscopic cholecystectomy. J Evolution Med Dental Sci. 2014;3(15):4061-71.
Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis. Int J Surg. 2015;18:196-204.
Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA. Meta-analysis of laparoscopic vs. open chlolecystectomy in elderly patients. World J Gastroenterology. 2014;20(46):17626-34.
Saeed T, Zarin M, Aurangzeb M, Wazir MA, Muqeem R. Comparative study of laparoscopic versus open chlolecystectomy. Pak J Surg. 2007;23(2):96-9.
Fajardo R, Valenzuela JI, Olaya SC, Quintero G, Carrasquilla G, Pinzón CE, et al. Cost-effectiveness of laparoscopic versus open cholecystectomy. Biomedica. 2011;31(4):514-24.
Solanki K, Parmar H, Gohil V, Shah S. Comparative study between open v/s laparoscopic cholecystectomy. NJIRM. 2010;1(1):18-20.
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