OPERATIVE METRICS IN LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY

Abstract

Laparoscopic cholecystectomy (LC) has become the standard procedure for gallbladder disease, though open cholecystectomy (OC) continues to be performed in selected cases. Comparative evaluation of operative metrics provides valuable insight into surgical performance, safety, and evolving techniques.

Objective: To compare operative time, intra-operative events, postoperative recovery, complications, and hospital stay between LC and OC, using operative data.

Materials and Methods: The study included 186 patients who underwent LC (n = 132) or OC (n = 54) for symptomatic gallstone disease at a tertiary care teaching hospital. Data were extracted from operative registers, anaesthesia notes, and inpatient case files. Key metrics included operative duration, blood loss, conversion rate, postoperative pain, wound complications, and hospital stay. Statistical analysis was performed using t-test and Chi-square test, with significance set at P < 0.05.

Results: LC demonstrated significantly shorter operative time (58.4 ± 12.8 vs 82.3 ± 16.5 minutes, P < 0.001), reduced blood loss (47.2 ± 18.4 vs 112.6 ± 35.7 mL, P < 0.001), and fewer wound complications (3.7% vs 14.8%). Conversion to open occurred in 6 cases (4.5%). Postoperative pain was lower in LC, with most patients requiring only NSAIDs, whereas 63% of OC patients required opioids. Mean hospital stay was significantly shorter in LC (2.6 ± 1.1 vs 6.1 ± 1.8 days, P < 0.001).

Conclusion: Laparoscopic cholecystectomy demonstrated superior operative and postoperative outcomes compared with open cholecystectomy, including shorter operative duration, reduced blood loss, fewer complications, and faster recovery. While LC remains the preferred technique, OC continues to play a vital role in complicated cases.