COMPARATIVE EVALUATION OF PERIOPERATIVE OUTCOMES IN LAPAROSCOPIC VERSUS OPEN CHOLECYSTECTOMY: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE CENTER IN NORTH INDIA
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Keywords
Laparoscopic cholecystectomy; Open cholecystectomy; Gallstone disease; Postoperative outcomes; Minimally invasive surgery; Hospital stay
Abstract
Background: Cholelithiasis is a common surgical condition requiring cholecystectomy as definitive management. Laparoscopic cholecystectomy has largely replaced open cholecystectomy due to its minimally invasive nature; however, comparative evaluation in regional settings remains essential.
Objectives: To compare perioperative outcomes between laparoscopic and open cholecystectomy in patients with symptomatic gallstone disease in a tertiary care hospital in North India.
Methods: A prospective comparative observational study was conducted from February 2012 to October 2012, including 90 patients diagnosed with symptomatic cholelithiasis. Patients were allocated into two groups: laparoscopic cholecystectomy (n=45) and open cholecystectomy (n=45). Data on operative time, postoperative pain, time to ambulation, duration of hospital stay, and complications were collected and analyzed using SPSS version 20.0. Statistical significance was considered at p<0.05.
Results: Baseline demographic characteristics were comparable between the groups. The laparoscopic group demonstrated significantly shorter operative time compared to the open group. Postoperative pain scores were significantly lower in the laparoscopic group, with earlier ambulation and faster return to normal activities. The overall complication rate was significantly lower in the laparoscopic group (13.3%) compared to the open group (31.1%). Additionally, the duration of hospital stay was significantly shorter in the laparoscopic group (2.8 ± 0.9 days) compared to the open group (5.6 ± 1.4 days).
Conclusion: Laparoscopic cholecystectomy is a safe and effective alternative to open cholecystectomy, offering superior perioperative outcomes. It should be considered the preferred surgical approach for gallstone disease in tertiary care settings.
References
2. Unisa S, Jagannath P, Dhir V, Khandelwal C, Sarangi L, Roy TK. Population-based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic basin of North India. Hpb. 2011 Feb 1;13(2):117-25.
3. Strasberg SM. Acute calculous cholecystitis. New England Journal of Medicine. 2008 Jun 26;358(26):2804-11.
4. Keus F, Gooszen HG, van Laarhoven CJ, Cochrane Hepato‐Biliary Group. Open, small‐incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. An overview of Cochrane Hepato‐Biliary Group reviews. Cochrane database of systematic reviews. 1996 Sep 1;2010(2).
5. Reynolds Jr W. The first laparoscopic cholecystectomy. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2001 Jan;5(1):89.
6. Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV. Mortality and complications associated with laparoscopic cholecystectomy: a meta-analysis. Annals of surgery. 1996 Nov 1;224(5):609-20.
7. Livingston EH, Rege RV. A nationwide study of conversion from laparoscopic to open cholecystectomy. The American journal of surgery. 2004 Sep 1;188(3):205-11.
8. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. The American journal of surgery. 1993 Jan 1;165(1):9-14.
9. Arabi YM, Tamim HM, Rishu AH, Bilotta F, Caramia R, Paoloni FP. Bibliography Current World Literature Vol 23 No 5 October 2010. J Trauma. 2010;68:904-11.
10. Agrawal R, Sood KC, Agarwal B. Evaluation of Early versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis. Surg Res Pract. 2011;2011:349801.
11. Barkun JS, Sampalls JS, Fried G, Wexler MJ, Meakins JL, Taylor B, Barkun AN, Goresky CA, Sampalis JS. Randomised controlled trial of laparoscopic versus mini cholecystectomy. The Lancet. 1992 Nov 7;340(8828):1116-9.
12. Aj M. Laparoscopic versus minilaparotomy cholecystectomy: A randomised trial. Lancet. 1994;343:135-8.
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Dr. Vinod Kumar
Associate Professor, Department of General Surgery, Mata Gujri Memorial Medical College & Lions Seva Kendra Hospital, Kishanganj, Bihar, India.
Dr. Hira Prasad Singh
Associate Professor, Department of General Surgery, Mata Gujri Memorial Medical College & Lions Seva Kendra Hospital, Kishanganj, Bihar, India.
Dr. Atul Kumar Soni
Assistant Professor, Department of General Surgery, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India.
