Morbidity of Complicated Gallstone Disease with Surgical Management: Comparison between Laparoscopic and Open Cholecystectomy

Abstract

Objective: To compare the outcomes of laparoscopic cholecystectomy with open cholecystectomy in patients with complicated gallstone disease.

Methodology: This prospective, randomized controlled trial study conducted at the general surgery department, Bakhtawar Amin Medical and Dental College Multan from January 2021 to December 2022, focused on patients with complicated gallstone disease diagnosed on basis of ultrasonography the patients were divided into two groups, Group A for open cholecystectomy and Group B for laparoscopic cholecystectomy by simple randomization method. Main variables of study were post-operative infection, pain score, hospital stay and mobilization time. SPSS version 27 was used for data analysis.

Results:  Severity of pain was mild in 16 (17.8%) and 29 (32.2%) patients of OC and LC groups respectively. Whereas, pain was severe in 28 (31.1%) and 25 (27.8%) patients of OC and LC groups respectively, (p=0.076). According to complications, chest infection was most common in 30 (33.3%) LC group, (p<0.001). The average mobilization time in OC and LC groups was 16.78±8.51 hours and 15.78±9.74 hours, respectively, (p=0.469). While, length of hospital stay in OC was higher than LC group, 5.91±2.45 days and 2.97±1.89 days, respectively. (p<0.001).

Conclusion:  Laparoscopic cholecystectomy is a safe and effective treatment for complicated gallstone disease in many cases. It offers several advantages, including minimal invasiveness, shorter hospitalization, early mobilization, and faster recovery. However, the decision on the surgical approach should be individualized based on the patient's specific condition and the surgeon's judgment.