Abdul Majeed, Zain Tayyab, Imran Yousuf, Farooq Ahmed, Aslam Javed.
The outcome of a comparative study of laparoscopic versus open cholecystectomy in the management of acute cholecystitis.
J Allama Iqbal Med Coll Jan ;19(4):863-7.

Background: Since the invention of laparoscopy in 1987, it has been a debatable issue whether laparoscopic cholecystectomy/ open cholecystectomy is better and superior in the management of acute cholecystitis; not responding to conservative management. A systematic review and metanalysis is hereby done to find out which one of two interventions is better in management of acute cholecystits when surgicallty intervened. The survey was done by manual performas filling individually considering acute cholecystitis as a pivot of the study. Methods: An approval from hospital ethics committee was attained. A systematic review with meta analysis of trials for comparison of open versus laparoscopic cholecystectomy in patients with AC was performed and evaluated . Electronic media searches were performed keeping Pubmed. Cochrane central register of controlled trials (CCTR) & Medline in use. The open hand perform containing open/closed question was distributed among patients as well as surgeons free of restrictions . Results: The inclusion of 2 trials was brought under consideration with a total of 513 patients by collecting data from various government teaching hospital in Lahore (Pakistan) in last 5 years. 287 in the OC and 213 in the LC groups. 13 patients left the hospital against medical advice after admission. The post operative morbidity was half with LC (OR=0.45). The post operative wound infection & pneumonia rates were by LC (OR=0.50 and 0.51 respectively). The post operative mortality rate was reduced by LC (OR=0.184). The mean postoperative hospital stay was shortened in the LC group (MD=-4.35 days).But there were no significant differences in the bile leakages intraoperative blood loss and operative times. Conclusion: Open surgery is the mother of all minimal invasive techniques(MITs) when MITs failed.

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