A comparative study of open versus laparoscopic cholecystectomy
Journal Title: MedPulse -International Medical Journal - Year 2016, Vol 3, Issue 2
Abstract
Introduction: Acute cholecystitis is a serious surgical emergency for elderly patients. Laparoscopic cholecystectomy (LC) is the gold standard operation for uncomplicated cholecystolithiasis. Aims and Objectives: To Study Open versus Laparoscopic Management of Cholecystectomy. Methodology: This is a prospective study conducted at Tertiary Care Hospital during the period March 2013 to March 2014 after obtaining approval from the Institutional Ethics Committee. All the patients between the ages of 17 to 70 yr. who were having chronic bile stones disease, who required surgical intervention in the form of cholecystectomy were included into study while patients with asthma, those who didn’t give consent, COPD, obese, immuno-compromised diseases were excluded from the study. Total 42 patients who were eligible for the cholecystectomy surgery, out them randomly 21 were enrolled into Laparoscopic cholecystectomy surgery Group (Group A) and Open cholecystectomy surgery (Group B) randomly, by computer generated random numbers. The statistical analysis done by unpaired t-test test and Z-test (Difference between two Proportions). Result: Mean Age was 45.62± 10.2 Yrs. In Group A and 47.5 ± 9.8 Yrs. Group B they were comparable to each other (p>0.05). Mean time required for surgery in Group A was 90± 12 min. and in Group B was 45±11min. which was significantly higher (p<0.05). Post operatively Pain was more in Group B i.e. Visual Analogue Score was 7.5±2.2 and 5.4±1.2 in Group A which was significantly higher (p<0.05). Average Hospital Stay was more in Group B as compared to Group A i.e. 4±2days and 2± 1 days which is statistically significant (P<0.05) Bleeding was more common in Group B i.e. 23.80% as compared to Group A 14.28%) which was statistically significant (P<0.05). CBD injury was more common in Group A as compared to Group B i.e. 33.33% and 4.76%respectively. Wound infection was also more common Group B i.e. 19.04% and 4.76% respectively which was significant (P<0.05). Conclusion: Post operatively Pain, Average Hospital Stay, Bleeding and infection rate were less in Laparoscopic surgeries while Mean time required for surgery and Bile duct injuries were more common for Laparoscopic Cholecystectomy surgeries. These advantage and disadvantages of each group should be considered while treating the patients.
Authors and Affiliations
Sujan Narayan Agrawal
Keywords
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