World Journal of Laparoscopic Surgery

Register      Login

VOLUME 1 , ISSUE 3 ( September-December, 2008 ) > List of Articles

RESEARCH ARTICLE

Comparison in Terms of Postoperative Morbidity and Hospital Stay between Open Cholecystectomy and Laparoscopic Cholecystectomy

Rooh-ul-Muqim, Faryal Gul Afridi, Javeria Iqbal, Jehangir Akbar, Zahoor Khan, M Zarin, Samiullah, Mohammad Aziz Wazir

Citation Information : Rooh-ul-Muqim, Afridi FG, Iqbal J, Akbar J, Khan Z, Zarin M, Samiullah, Wazir MA. Comparison in Terms of Postoperative Morbidity and Hospital Stay between Open Cholecystectomy and Laparoscopic Cholecystectomy. World J Lap Surg 2008; 1 (3):17-21.

DOI: 10.5005/jp-journals-10007-1064

Published Online: 01-12-2010

Copyright Statement:  Copyright © 2008; The Author(s).


Abstract

Type of study

Comparative.

Aim

To compare the postoperative morbidity in terms of postoperative pain, gait disturbances, wound and respiratory infections along with length of hospital stay in patients undergoing laparoscopic cholecystectomy with those undergoing open surgery for symptomatic gallstone disease to compare the effectivity of minimally invasive surgery with open surgery in reducing postoperative morbidity and thus length of hospital stay.

Place and duration of study

Surgical Unit Khyber Teaching Hospital, Peshawar, Pakistan; from July 2006 to December 2006.

Materials and methods

This study included a total of 50 patients who underwent either open or laparoscopic cholecystectomy in our unit (SDW KTH). Their clinical data, admission dates and date of surgery were noted. Postoperative progress was followed and requirement of analgesia, nausea, vomiting, febrile morbidity, wound infections and respiratory tract infections, if any were noted. Their date of discharge from hospital was also recorded. Re-admission (if any) for any complication of surgery was noted and further days spent in hospital were recorded. This data was analyzed to see the post-operative morbidity and length of hospital stay in these patients.

Results

Out of the 50 patients included in this study, the mean hospital stay for the patients who underwent laparoscopic cholecystectomy was 2.06 days as against 3.93 days for those having open surgery for symptomatic gallstone disease. Also pain (and thus analgesia requirement) and other complications were significantly lower for the patients who had minimally invasive surgery indicating the superiority of laparoscopic technique as regards postoperative hospital stay and morbidity.

Conclusion

Minimally invasive surgery is infact very effective in reducing postoperative morbidity and thus hospital stay in patients with gallstones. Although open cholecystectomy is still performed in our hospitals, the time is near when it will be largely replaced by the laparoscopic technique.


PDF Share
  1. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev, 2006; (4):CD006231.
  2. J, et al. Retrospective and prospective multi-institutional laparoscopic cholecystectomy study by the Society of American Gastrointestinal Endoscopic Surgeons. Surg Endosc 1992;6:169-76.
  3. Comparison of frequency of wound infection: open versus laparoscopic cholecystectomy. Ayub Med Coll Abbottabad. 2006;18(3):21-24.
  4. Post-operative pain- comparison between laparoscopic and open cholecystectomy. A two year experience. Pak Postgraduate Medical Journal 2000;2(1):44-46.
  5. Sonographically determined clues to the symptomatic or silent cholelithiasis. J Coll Physicians Surg Pak 2007;17(11):654-57.
  6. Pattern of gallbladder diseases in Pakistan. Pak J Med Sci 1999;15:109-12.
  7. The pattern of diseases in a surgical unit at a tertiary care public hospital of Karachi. Pak J Med Sci 2004;20:311-14.
  8. Contemporary minimally invasive approaches to the management of acute cholecystitis: a review and appraisal. Surg Laparosc Endosc Percutan Tech 2005;15:1-8.
  9. Open cholecystectomy in the laparoscopic era. Br J Surj 2007;94:1382-85.
  10. Complications of cholecystectomy. Surg Clin N Am 1994;74:809-23.
  11. The incidence and causes of death following surgery for non-malignant biliary tract disease. Ann Surg 1980;191:271-75.
  12. ASA physical status and age predict morbidity after three surgical procedures. Ann Surg 1994;220:3-9.
  13. Multivariate comparison of complications after laparoscopic cholecystectomy and open cholecystectomy. Ann Surg 1995;221:381-86.
  14. Age and Aging 1997;26:77-81.
  15. Laparoscopic laser cholecystectomy. Surg Endosc 1989;3:131-33.
  16. Mini-laparoscopic cholecystectomy vs laparoscopic cholecystectomy. Surg Endosc 2001;15(6):614-18.
  17. Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 2003, 17(10):1624-27.
  18. Threeport microlaparoscopic cholecystectomy in 159 patients. Surg Endosc 2001;15(3):293-96.
  19. Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc 2003, 17(9):1434-36.
  20. Measurement of postoperative pain: analysis of the sensitivity of various selfevaluation instruments. Rev Esp Anestesiol Reanim 2003;50(5):230-36.
  21. Three port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis. BMC Surgery 2007, 7;8. Published online 2007 June 13. doi: 10.1186/1471-2482-87-88.
  22. Laparoscopic versus open cholecystectomy: Hospitalization, sick leave, analgesia and trauma responses. Br J Surg 1994;81(9):1362-65.
  23. A financial analysis of laparoscopic and open cholecystectomy. Surgical Endoscopy 1995;9(6):702-05.
  24. Laparoscopic converted to open cholecystectomy minimally prolongs hospitalization. Am J Surg 2005;190:888-90.
  25. Small-incision (minilaparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbeck's Archives of Surgery 2004;389(3):172-77.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.