Comparative study of morbidity of laparoscopic versus open cholecystectomy in complicated gallstone disease

Abstract

Background: Gallstone disease is a major health problem worldwide particularly in the adult population. Previously complicated gallstone disease was considered to be a contraindication for laparoscopic cholecystectomy. This initial reluctance has slowly evaporated as a result of increasing expertise. The aim of study was to compare the outcome of laparoscopic with open cholecystectomy in patients with complicated gallstone disease.

Material & Methods: This study was carried out in Surgical Unit-IV, Liaquat University Hospital Jamshoro, from January 2008 to December 2009. One hundred patients were divided in two groups of 50 each; Group A for open Cholecystectomy (OC) and group B for laparoscopic cholecystectomy (LC). Data was analyzed using SPSS software.

Results: Out of 100 patients there was female preponderance with male to female ratio of 1:1.5 in group A and 1:3.5 group B. The mean age was 41.28±12.30 years for group A and 38.44±13.50 for group B. Ultrasound findings revealed was single stone [13(26%) patients in OC vs 10 (20%) patients in LC group], multiple stones [37(74%) patients in OC vs 40 (48%) patients in LC group], Impacted stone [15(30%) patients in OC vs 18 (36%) patients in LC group], Thick wall gallbladder [26(52%) patients in OC vs 25(50%) patients in LC group], empyma [6(12%) patients in OC vs 8(16%) patients in LC group], mucocele [3(6%) patients in OC vs 5(10%) patients in LC group], contracted [7(14%) patients in OC vs 8(16%) patients in LC group]. Operative time range 30 minutes to 90 minutes in both groups. The mean time in OC group was 54.90±15.90 minutes and LC group was 48.30±12.96 minutes (p 0.026). No mortality was reported in this series.

Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment of complicated gallstone disease.