Open cholecystectomy: a control group for comparison with laparoscopic cholecystectomy

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical History

Background:

• Laparoscopic cholecystectomy is increasingly preferred for symptomatic cholelithiasis.
• Randomized trials comparing laparoscopic and open cholecystectomy are scarce.
• Historical controls are needed to evaluate laparoscopic cholecystectomy efficacy.

Purpose of the Study:

• To establish a historical control group of open cholecystectomy patients.
• To compare outcomes between open and laparoscopic cholecystectomy.
• To document the characteristics of open cholecystectomy procedures.

Main Methods:

• Retrospective study of 457 open cholecystectomy patients (1985-1989).
• Data collected on operative duration, postoperative stay, and complications.
• Comparison with contemporary laparoscopic cholecystectomy data.

Main Results:

• Mean operative time for open cholecystectomy was 73 minutes (118 min with common bile duct exploration).
• Postoperative stay ranged from 5.3 days (elective) to 12.0 days (urgent with exploration).
• Complication rates were 35.2% (cholecystectomy) and 62.5% (exploration), reducing to 6.8% and 20.1% excluding atelectasis.

Conclusions:

• Open cholecystectomy demonstrated significant morbidity, particularly with common bile duct exploration.
• Laparoscopic cholecystectomy likely offers improved outcomes compared to this historical open cholecystectomy cohort.
• This study provides a valuable benchmark for evaluating the benefits of minimally invasive gallbladder surgery.