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Comparison of laparoscopic and open cholecystectomy at Prince Abdulrahman Al Sudairy Hospital, Saudi Arabia
F H al Hadi1, L C Chiedozi, M M Salem
1Department of Surgery, Prince Abdul Rahman Al Sudairy Hospital, Sakaka, Al Jouf, Saudi Arabia.
Insights
Laparoscopic cholecystectomy (LC) offers better outcomes than open cholecystectomy (OC) for symptomatic gallstones. LC resulted in less pain, fewer complications, and shorter hospital stays, making it the preferred surgical option.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Technology
Background:
- Symptomatic cholelithiasis (gallstones) management historically relied on open cholecystectomy (OC).
- Laparoscopic cholecystectomy (LC) emerged as a less invasive alternative.
Purpose of the Study:
- To compare the efficacy and outcomes of LC versus OC for symptomatic cholelithiasis.
- To evaluate the safety and feasibility of LC as a primary surgical approach.
Main Methods:
- A retrospective comparison of 300 patients undergoing LC with 300 matched patients who underwent OC.
- Analysis of operative success rates, conversion rates, postoperative pain, hospital stay duration, and complication rates.
Main Results:
- LC achieved a 97.3% success rate with only a 2.7% conversion rate to OC.
- LC patients experienced significantly less postoperative pain (0.01 vs. 5 opiate doses, p < 0.0001) and shorter hospital stays (3.1 vs. 8 days, p < 0.001).
- Postoperative complications were lower in the LC group (4% vs. 11% for OC).
Conclusions:
- Laparoscopic cholecystectomy is a superior surgical procedure compared to open cholecystectomy for symptomatic cholelithiasis.
- LC can be safely adopted as the preferred treatment modality in regional centers, supplanting OC.
Abstract:
The initial 300 patients whose symptomatic cholelithiasis was managed by laparoscopic cholecystectomy (LC) were matched to and compared with 300 patients managed by open cholecystectomy (OC) during the 30 months prior to the introduction of LC. Of the 300 LC attempted 292 (97.3%) were successful with conversion to OC rate of 2.7%. Besides the obviously better cosmetic results, LC patients had less post operative pain, mean doses of opiates needed 0.01 versus 5 for OC (p < 0.0001), were discharged earlier from the hospital, mean 3.1 days versus 8 days for OC (p < 0.001) and had less postoperative complications 4% versus 11% for OC. We conclude that not only is LC a better operation than OC, but also that in the regional referral centres such as ours, LC can safely supplant OC as the preferred modality for the management of symptomatic cholelithiasis.
