A Comparative Analysis between Laparoscopic and Open Cholecystectomy at a Tertiary Care Hospital in Patients with Acute Cholecystitis

Authors

  • A V Akulwar
  • Ajonish Kamble
  • Neha Bhatt
  • chandrasekhar Mahakalkar

DOI:

https://doi.org/10.37506/ijfmt.v15i3.15426

Keywords:

Acute Cholecystitis, Laparoscopic Cholecystectomy, Open Cholecystectomy

Abstract

Background: Acute cholecystitis is clinically characterized as an episode of acute biliary pain; fever and
right hypochondrial tenderness with symptoms persistence exceeding 24 hours.
Aims & Objectives: We compared and analyzed open and laparoscopic cholecystectomy in the current
study on the basis of the duration of the operation, intra and postoperative complications and the length of
hospital stay & return to work.
Material and Methods: This was a prospective comparative, randomized hospital-based study performed
in patients of 20 - 80 years of age with acute cholecystitis in the Department of General Surgery from July
2019 to January 2021 at SMH&RC, Datta Meghe Medical College Nagpur. Patients were divided randomly
into two classes as Open cholecystectomy (60 patients) and laparoscopic cholecystectomy (60 patients). The
key assessed outcome was death, peri-operative & post-operative complications; length of hospital stay and
wound infection, return to work. The gathered data was statistically analyzed.
Results: In both categories, the most common age group was 40-59 years old. The female population (78%)
was greater than the male population (22 percent). 1: 3.6 was the male to female ratio. The mean time
needed for open cholecystectomy was 53.18 ± 12.74 minutes, while 38.37 ± 6.21 minutes for laparoscopic
cholecystectomy, and the difference was statistically important. 2 (3.3 percent) laparoscopic procedures
involved conversion to open surgery due to difficult dissection, bleeding & blurred vision. In terms of postoperative pain (VAS > 4), hospital stay period and return to work, laparoscopic cholecystectomy had better
outcomes than open cholecystectomy and the difference was statistically important. In Open Cholecystectomy
patients, wound infection, post-operative paralytic ileus was substantially greater. There were 2 patients with
wound dehiscence from open cholecystectomy. No significant morbidity or any mortality during the study
period was reported.
Conclusion: Laparoscopic cholecystectomy provides decisive advantages over open cholecystectomy in
acute cholecystitis (e.g. shorter time of surgery, fewer post-operative complications, less paralytic ileus, less
analgesic use, early discharge and mobilization).

Author Biographies

A V Akulwar

Professor & HOD Dept. of Surgery, Datta Meghe Medical College Shalinitai
Meghe Hospital and Research Centre, Nagpur

Ajonish Kamble

Senior Resident Dept. of Surgery, Datta Meghe Medical College Shalinitai
Meghe Hospital and Research Centre, Nagpur

Neha Bhatt

Assistant Professor Dept. of Pathology Datta Meghe Medical
College Shalinitai Meghe Hospital and Research Centre, Nagpur

chandrasekhar Mahakalkar


Professor Dept. of Surgery Jawaharlal Nehru
Medical Sciences Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha4
Professor Dept. of Surgery Jawaharlal Nehru
Medical Sciences Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha

Published

2021-05-17

How to Cite

A V Akulwar, Ajonish Kamble, Neha Bhatt, & chandrasekhar Mahakalkar. (2021). A Comparative Analysis between Laparoscopic and Open Cholecystectomy at a Tertiary Care Hospital in Patients with Acute Cholecystitis. Indian Journal of Forensic Medicine & Toxicology, 15(3), 894-899. https://doi.org/10.37506/ijfmt.v15i3.15426

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