Javaid Iqbal, Bashir Ahmad, Qamar Iqbal, Abdul Rashid.
Laparoscopic V/s open Cholecystectomy morbidity comparison.
Professional Med J Jan ;9(3):226-35.

OBJECTIVE: To find out the morbidity and its determinants with laparoscopic cholecystectomy (LC) and to compare it with that open cholecystectomy (OC). STUDY DESIGN: Surgical unit-IV, DHQ Hospital, Punjab Medical College, Faisalabad; the study of both OC and LC groups was conducted from January 1st to December 31st, 2000 and from January 1st to December 31st 2001 respectively. SUBJECT & METHODS: 123 patients underwent surgical treatment for gallstones disease by LC and 58 patients were subject to elective OC. The patients of two groups were matched regarding their age, sex Anesthetic risks, and difficulties during surgery, postoperative complications and hospital stay. RESULTS: Average age of the patients was 44.13 years and 42.90 years in LC and OC groups with female to male ratio 91.06% : 8.94% and 93.10% : 6.9% in LC and OC groups, respectively. Per-operatively, 3.45% (two) patients developed common bile duct injury in OC group and morbidity due to this complication remained 0% in LC group. 4.06% (five) patients of LC and 5.17% (three) cases of OC had non-significant hemorrhage and slight bile leak from gall bladder bed. In laparoscopic group, conversion to OC was required in 7.31% (nine) patients. Post operatively, morbidity due to pain, fever, nausea and vomiting, respiratory and wound complications were significantly less in LC group as compared to OC group. Mean durations for tolerating oral feedings and post-operative hospital stay were found to be shorter in LC group than in OC group. CONCLUSION: We conclude that with low threshold of conversion laparoscopic cholecystectomy is the safe choice than open cholecystectomy with low morbidity and shorter hospital stay. It is replacing the OC as a new gold standard against which new therapies will be compared in future.

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