COMPARISON OF MANAGEMENT OUT COMES OF OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY IN THE TREATMENT OF SYMPTOMATIC CHOLELITHIASIS

Abstract

Objective: Our objective was to compare the management outcomes of laparoscopic cholecystectomy with those of open cholecystectomy in the treatment of symptomatic cholelithiasis.
Study Design: Quasi experimental study.
Settings: It was carried out at Surgical Unit - I of Holy Family Hospital, Rawalpindi.
Subjects and Methods: Eighty consecutive patients with symptomatic cholelithiasis confirmed on ultrasonography from September 2007 to March 2008 were included in the study. They were randomly allocated to LC or OC and were eventually operated.
Results: Mean operating time of LC was 64 minutes (30-90) (SD=13.4) where as in OC it was 37.12 minutes (25-70) (SD-9.6). Return of bowel sounds postoperatively was within 12 hours (9-18) (SD=3.25) in LC while it was 16 hours (9-30) in OC group (SD=4.75). Postoperative hospital stay was 1.5 days mean (1-4 days) (SD=0.71). In LC while it was 2.9 days (2-5) in OC group (SD=0.84). The duration of injectable analgesia requirement was 1.3 days (1-3) (SD=0.51) and 1.8 days (1-3) (SD=0.7) in LC and OC patients respectively. The gall bladder perforation was 22.5% in OC and 15% in LC. The common bile duct injury occurred in 2% of patients with LC while none with
OC. The conversion rate was 5%.
Conclusion: Laparoscopic cholecystectomy is safe treatment of cholelithiasis with short duration of postoperative
hospital stay, lesser post operative pain, early return of normal bowel activity as compared to the open cholecystectomy.