Evaluating the Outcomes of Laparoscopic versus Open Cholecystectomy in a Community Hospital Setting
Laparoscopic vs. Open Cholecystectomy Interventions
Keywords:
Gallstones, Pain, Operation, RecoveryAbstract
Background: Gallstone obstruction is the most common reason for presenting acute cholecystitis (AC), where inflammation may have dire consequences. Given that the laparoscopic cholecystectomy (LC) process is minimally invasive and more beneficial than other surgical operations such as open cholecystectomy (OC).
Methods: This was a prospective observational study comparing LC and OC in a one-year follow-up from a community hospital in Larkana. Descriptive statistics and inferential tests apply to collect and analyze data on patient demographics, surgical details, postoperative problems, and recovery factors.
Results: Out of the 70 patients, 50 had LC, and 20 had OC. Significantly shorter hospital stays (2.3±1.1 days) and surgical times (75.2±20.4 minutes vs. 105.6±25.3 minutes, p<0.001) were linked to LC. The LC group experienced shorter recovery times (10.4± 3.7 days vs. 18.6±5.2 days, p<0.001) and lower postoperative pain levels (3.2±1.1 vs. 5.6±1.7, p<0.001). Although the OC group had proportionally greater rates of gastrointestinal problems, wound infections, and bleeding, the differences were not statistically significant.
Conclusion: A shorter operative time, less hospitalization, less postoperative pain score, and faster recovery were observed with LC compared to OC. Further studies are needed to confirm these results; thus, LC is recommended as the surgical strategy of choice for AC.
References
de Araújo Gomes MJ, de Figueiredo BQ, de Menezes AG, Júnior ÁN, Carvalho BC, Roehrs DD, Loureiro LS, Nunes NA, Borges CA, Machado KS. Acute cholecystitis: diagnosis, complications and therapy: an integrative literature review. Research, Society and Development. 2022 Nov 13;11(15):e322111537469-.
Portincasa P, Di Ciaula A, Bonfrate L, Stella A, Garruti G, Lamont JT. Metabolic dysfunction-associated gallstone disease: expecting more from critical care manifestations. Internal and Emergency Medicine. 2023 Oct;18(7):1897-918.
Gutt C, Schläfer S, Lammert F. The treatment of gallstone disease. Deutsches Ärzteblatt International. 2020 Feb;117(9):148.
Rop N. Incidence and Outcomes of Bile Duct Injury Following Laparoscopic Cholecystectomy at Kenyatta National Hospital (Doctoral dissertation, University of Nairobi).
Lim RB, Condon F, Conrad R. The History of Minimally Invasive Techniques in Acute Care Surgery. InMini-invasive Approach in Acute Care Surgery 2023 Nov 10 (pp. 1-15). Cham: Springer International Publishing.
Wang X, Yu W, Jiang G, Li H, Li S, Xie L, Bai X, Cui P, Chen Q, Lou Y, Zou L. Global Epidemiology of Gallstones in the 21st Century: a systematic review and Meta-analysis. Clinical Gastroenterology and Hepatology. 2024 Feb 19.
Weerakoon H, Vithanage I, Alahakoon O, Weerakoon K. Clinico-epidemiology and aetiopathogenesis of gallstone disease in the South Asian region: a scoping review protocol. BMJ open. 2022 Jun 1;12(6):e057808.
Faiz A, Syed MA, Mahmood SE, Ahmad A, Narapureddy BR, Zeyaullah M, Muzammil K, AAG DA, Nasar A, Singh A. Prospective Study on Association of Histopathological Changes in Gallbladder Mucosa with the Type of Gallbladder Stones.
Black CJ, Drossman DA, Talley NJ, Ruddy J, Ford AC. Functional gastrointestinal disorders: advances in understanding and management. The Lancet. 2020 Nov 21;396(10263):1664-74.
Pollard JH. Hepatobiliary Imaging. Radiology‐Nuclear Medicine Diagnostic Imaging: A Correlative Approach. 2023 Apr 7:456-84.
Chattopadhyay K, Das R. Laparoscopic and open cholecystectomy: a comparative study. International J Surg Sci. 2020;4(1):427-30.
Alkatout I, Mechler U, Mettler L, Pape J, Maass N, Biebl M, Gitas G, Laganà AS, Freytag D. The development of laparoscopy—a historical overview. Frontiers in surgery. 2021 Dec 15;8:799442.
D’Acapito F, La Barba G, Togni C, Ercolani G. Difficult Laparoscopic Cholecystectomy: When to Convert to Open Technique. Difficult Acute Cholecystitis: Treatment and Technical Issues. 2021:101-17.
Lin YN, Wu YT, Fu CY, Liao CH, Cheng CT, Wang SY, Lin BC, Hsu YP, Kang SC, Liu EH, Kuo IM. Evaluating the advantages of treating acute cholecystitis by following the Tokyo Guidelines 2018 (TG18): a study emphasizing clinical outcomes and medical expenditures. Surgical Endoscopy. 2021 Dec;35:6623-32.
Ietto G, Amico F, Pettinato G, Iori V, Carcano G. Laparoscopy in emergency: why not? Advantages of laparoscopy in major emergency: a review. Life. 2021 Sep 3;11(9):917.
Ganpathi IS, Diddapur RK, Eugene H, Karim M. Acute acalculous cholecystitis: Challenging the myths. HPB 2007;9:131–4. 17.
Mason RJ, Yacoub WN, Petrosyan M, Sehgal I, Ma Y, Chandrasoma P. Prediction of patients with acute cholecystitis requiring emergent cholecystectomy: A simple score. Gastroenterol Res Pract 2010.
Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, et al. Open versus laparoscopic cholecy-stectomy in acute cholecystitis. Systematic review and metaanalysis. Int J Surg 2015; 18:196–204.
Teixeira JA, Ribeiro C, Moreira LM, De Sousa F, Pinho A, Graça L, et al. Colecistectomia por Laparoscopia e por Laparotomia na Colecistite Aguda: Análise Crítica de 520 Casos. Acta Med Port 2014;27:685–91.
Antoniou SA, Antoniou GA, Koch OO, Pointner R, and Granderath FA. Metaanalysis of laparoscopic vs open cholecystectomy in elderly patients. World J Gastroenterol 2014;20:17626–34.
Boo YJ, Kim WB, Kim J, Song TJ, Choi SY, Kim YC, et al. Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis: A prospective randomized study. Scand J Clin Lab Invest 2007;67:207–14.
Catena F, Ansaloni L, Bianchi E, Di Saverio S, Coccolini F, Vallicelli C, et al. The ACTIVE (Acute Cholecystitis Trial Invasive Versus Endoscopic) study: Multicenter randomized, double-blind, controlled trial of laparoscopic versus open surgery for acute cholecystitis. Hepatogastroenterology 2013;60:1552–6.
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Copyright (c) 2024 Dr. Muhammad Hassan Abbas, Dr. Asif Nadeem, Dr. Mohtmam Nazir, Dr. Batool Hassan Abbas, Dr. Muhammad Hassnain Abbas, Dr. Hussain Saeed
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