Title: A Comparative Study of Laparoscopic vs. Open Cholecystectomy in a Northwestern Medical School of Bihar
Authors: Dr Lalan Kumar, Dr Manish, Dr A.P. Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.225
Abstract
Introduction: Gallstones are common in Indian population and its treatment has shown a decisive shift from open to minimally invasive route. Undoubtedly, laparoscopy requires longer and steeper learning curve and incurs higher cost. However, preferences of patients are changing rapidly due to better level of awareness and availability of healthcare facility.
Aims: To compare laparoscopic Cholecystectomy vs. open Cholecystectomy in patients of cholelithiasis by measuring parameters such as use of Post-operative analgesia, Operative Time, Post-operative hospital stay, morbidity and mortality.
Material and Method: It is a prospective randomized study of 300 Patients of cholelithiasis aged between 20 years to 70 years operated during 2013-2016 at Government Medical College, Bettiah & associated MJK hospital. They were divided into open and laparoscopic Cholecystectomy groups by drawing a lottery. Patient’s written valid informed consent for the particular procedure was taken and the advantages and disadvantages of both the operative procedure were explained in detail to the patients.
Results: The median (range) operation time for laparoscopic cholecystectomy was 55-170 min (mean=105 min) and 38-92 min (mean=70 min) for open cholecystectomy (p<0.001). 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). Conversion rate in literature in laparoscopic cholecystectomy ranges from 3% to 15% in well trained hands. In our series it was 8 %.
Conclusion: Laparoscopic cholecystectomy is better than open cholecystectomy in terms of post-operative pain, analgesic requirement and early return to work. However, open cholecystectomy is preferable for Surgeons in training and in cases of complicated cholecystectomy.
Keywords: Cholelithiasis; Cholecystitis; Minimally invasive surgery; Laparoscopic cholecystectomy; Open cholecystectomy; Bile duct injury.
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