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Which Is More Effective: Laparoscopic or Open Partial Cholecystectomy?
Idris Kurtulus1, Osman Deniz Culcu1, Mahmut Said Degerli2
1Department of General Surgery, Basaksehir State Hospital, Istanbul, Turkey.
Summary
Laparoscopic partial cholecystectomy (LPC) offers significant advantages over open partial cholecystectomy (OPC), including shorter operation times and reduced complication rates. While both procedures carry risks, LPC demonstrates better outcomes in terms of recovery and infection prevention.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Minimally Invasive Surgical Techniques
- Surgical Outcomes Research
Background:
- Partial cholecystectomy is employed when anatomical clarity is insufficient to prevent bile duct injury during cholecystectomy.
- Surgeons may opt for a laparoscopic or open approach for partial cholecystectomy.
- This study compares the efficacy of laparoscopic versus open partial cholecystectomy.
Purpose of the Study:
- To compare the effectiveness of laparoscopic partial cholecystectomy (LPC) and open partial cholecystectomy (OPC).
- To evaluate operative time, hospital stay, and complication rates between the two techniques.
Main Methods:
- Retrospective review of 4712 patients undergoing cholecystectomy between 2012 and 2020.
- Inclusion of 98 patients who underwent partial cholecystectomy, divided into OPC (n=52) and LPC (n=46) groups.
- Comparative analysis of clinical and outcome data between the two groups.
Main Results:
- LPC group showed significantly shorter mean operative time (87.3 min vs 118.2 min) and postoperative hospital stay (2.55 days vs 4.8 days) compared to OPC (P < .005).
- LPC was associated with a substantial reduction in wound infection (83.1% decrease) and incisional hernia rates (81.1% decrease) versus OPC (P < .05).
- Overall complication rates were lower in the LPC group (63% reduction; P = .049), with fewer patients experiencing at least one complication (7 vs 17).
Conclusions:
- Partial cholecystectomy indications are associated with inherent risks, irrespective of surgical approach.
- Laparoscopic partial cholecystectomy demonstrates clear advantages in reduced operative time, shorter hospital stay, and lower rates of wound infection, incisional hernia, and overall complications compared to the open approach.
- Surgeons should prioritize patient safety and consider converting to open cholecystectomy if intraoperative conditions or team experience are suboptimal.
