Open versus laparoscopic cholecystectomy: a retrospective comparative study

Two groups of 40 patients (31 females, 9 males), matched for age and body mass index, who underwent either elective open cholecystectomy (Group I) or elective laparoscopic cholecystectomy (Group II) have been studied retrospectively to detect differences in operating time, morbidity and mortality, hospital length of stay, and use of postoperative analgesics. The two groups of patients had almost identical histories of gallstone disease. The median operating time for the patients in Group I was 45 min (range 35-95) compared with 90 min (range 50-135) in Group II. An intraoperative cholangiogram was performed in 21 of the patients in Group I and 22 patients in Group II. There were no deaths in either group. The overall complication rate was 22.5% in Group I and 10% in Group II. Median postoperative length of stay was 5 days for Group I patients (range 1-19) and 2 days for Group II patients (range 1-5). All Group I patients required postoperative intravenous or intramuscular opiates, while 10% of Group II patients did not require any analgesia at all and pain was controlled with oral analgesics alone in 16%. Median total morphine dose for Group I patients was 46.9 mg (range 9.4-180), as compared with only 15.6 mg (6.2-37.5) for Group II patients. This study concludes that laparoscopic cholecystectomy led to less complications, shorter hospital length of stay, and minimal use of postoperative analgesia.