Title: Laparoscopic Cholecystectomy vs. Open Cholecystectomy in the Treatment of Acute Cholecystitis
Authors: Dr Lalan Kumar, Dr Manish , Dr A.P. Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.206
Abstract
Objective: To compare the results of laparoscopic cholecystectomy (LC) with those of open cholecystectomy (OC) in the treatment of acute cholecystitis.
Design: A prospective, nonrandomized trial.
Setting: Government medical college, Bettiah ,West Champaran
Patients:124 patients underwent LC, and 118 underwent OC. The patients underwent surgery within 48 hours of the onset of symptoms. The patients were selected for LC or OC depending on the patient's preference.
Main Outcome Measures: Operating time, Rate of conversion from LC to OC, complications, post operative pain, and length of hospital stay.
Results: Conversion from LC to OC was about in 12% of the patients. The mean operating time 82 minutes for the OC group and 102 minutes for the LC group (P<.001). Complications occurred in 14% of the patients in the LC group and in 23.7% of the patients in the OC group, with no significant differences between the 2 groups (P=.06). The number of moderate or severe complications was similar in both groups, whereas mild complications were more common in the OC group (P<.02). The use of parenteral analgesics in case of laparoscopic cholecystectomy (Mean no. of days=1.7) is considerably less than open cholecystectomy (Mean no. of days=3.7). The length of the hospital stay averaged 9.1 days for the OC group and 3.8 days for the LC group (P<.001).
Conclusions: Laparoscopic cholecystectomy is a safe, effective alternative to OC in patients with acute cholecystitis. The technique has a decreased rate of complications, a shorter hospital stay, and offers the patient a less uncomfortable postoperative period and also less pain.
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