DOI: http://dx.doi.org/10.18203/2349-3933.ijam20184748

A comparative study of laparoscopic (LC) vs. open cholecystectomy (OC) in a medical school of Bihar, India

Rajiv Ranjan, Kishore K. Sinha, Mahesh Chaudhary

Abstract


Background: Gallstone disease is a significant health problem world over (in both developing and developed nations). The incidence of gallstone disease increases after age of 40years and it becomes 4-10 times more common in old age. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. Laparoscopic cholecystectomy introduced in 1985 has become the procedure of choice for surgical removal of the gallbladder. The aim is to compare laparoscopic cholecystectomy and open cholecystectomy in patients of cholelithiasis by measuring parameters such as use of post-operative analgesia, operative time, post-operative hospital stays, morbidity, mortality and patient satisfaction.

Methods: It is a prospective randomized study of 120 patients of cholelithiasis aged between 20years to 80years operated during 2015-2018 at of Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. They were divided into open and laparoscopic Cholecystectomy groups by drawing a lottery.

Results: The median (range) operation time for laparoscopic cholecystectomy was 55-155 min (mean=102 min) and 40-105 min (mean=72 min) for open cholecystectomy (p <0.001). Form LC group 5 cases had to be converted to OC. Rate of conversion was 5/60=8.3% which is within limits of worldwide laparoscopic cholecystectomy conversion rate of 5% to 10%. LC was found to be superior to OC.

Conclusions: Laparoscopic cholecystectomy is better than open cholecystectomy However, open cholecystectomy is preferable in cases of complicated cholecystectomy.


Keywords


Bile duct injury, Cholelithiasis, Cholecystitis, Laparoscopic cholecystectomy, Open cholecystectomy

Full Text:

PDF

References


Bailey & Love's Short Practice of Surgery, 26th ed.; 2013:1106.

Mohan H, Punia RP, Dhawan SB, Ahal S, Sekhon MS. Morphological spectrum of gallstone disease in 1100 cholecystectomies in North India. Indian J Surg. 2005 Jun 1;67(3).

Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?. Current Gastroenterol Reports. 2005 Apr 1;7(2):132-40.

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.

Choy I, Kitto S, Adu-Aryee N, Okrainec A. Barriers to the uptake of laparoscopic surgery in a lower-middle-income country. Surgical Endoscopy. 2013 Nov 1;27(11):4009-15.

Ellis H. John Stough Bobbs: father of gall bladder surgery. Br J Hospital Medicine. 2009 Nov;70(11):650.

Traverso LW. Carl Langenbuch and the first cholecystectomy. Am J Surg. 1976 Jul 1;132(1):81-2.

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 Apr 1;127(4):405-11.

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 Jun 1;18:196-204.

Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA. Meta-analysis of laparoscopic vs open cholecystectomy in elderly patients. World Journal of Gastroenterology: WJG. 2014 Dec 14;20(46):17626-34.