Ishtiaq Ahmed, Shehzad Bashir, Zafar Ali Chowdry, Adnan Riaz.
Comparison of Early Morbidity in Open and Lap. Cholecystectomy for Ch Gallstones Disease.
Pak J Med Health Sci Jan ;13(1):126-30.

Background: Cholelithiasis is a major health problem through out the world. Traditional open cholecystectomy has long been accepted as gold standard treatment of gallstones. Introduction of laparoscopic cholecystectomy has dramatically changed the management of the patients with gallstones disease. There is significant increase in total number of gall bladder procedures performed laparoscopically. Aim: To compare morbidity in open and laparoscopic cholecystectomy in terms of per-operative iatrogenic injury to abdominal structures, early postoperative complications, duration of procedure and stay in Hospital. Methodology: It was a quasi-experimental study conducted at Department of General Surgery, Sir Ganga Ram Hospital Lahore. Total 100 patients diagnosed as chronic gallstones diseases were included in study and they were randomly distributed to group A (LC) and group B (OC), 50 in each group. Both groups were almost equal for demographic data. Group A was subjected to standard 4 ports laparoscopic cholecystectomy and group B was subjected to open cholecystectomy through standard right sub-costal incision. Results: There were 50 patients in group A, mean age was 44.55 yrs. (SD+/-8.71) and 8(16%) were male and 42(84%) were female, while 50 patients were in group B with mean age 46.83 yrs. (SD+/-9.71) and there were 9(18%) male and 41(82%) female. Postoperative hospital stay in group A was 1-5 days, mean 1.6 days (SD+/-1.7248) in group B while 2-7 days, mean 2.9 days (SD+/-2.0009) in group B. P-value = 0.012. In both the groups no per operative iatrogenic injury to CBD and duodenum was detected (0%). Duration of procedure in group A was 30 to 120 min. (mean 63 min.), while in group B it was 40 to 125 minutes (mean 61 min.). Wound infection was noted in 2(4%) patients in group A and 5 (10%) patients in group B. P-value is =0.727. Conclusion: Laparoscopic cholecystectomy is an effective and safe technique of treating symptomatic gallstones in experienced hands as compared to open cholecystectomy because of accelerated recovery, negligible wound infection and wound related complications, less postoperative pain and short hospital stay.

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