Laparoscopic Versus Open Cholecystectomy in Gangrenous Cholecystitis: A Retrospective Comparative Study

Area of Science:

• General Surgery
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gangrenous cholecystitis (GC) is a severe complication of acute cholecystitis.
• GC is associated with increased operative difficulty and postoperative morbidity.
• The optimal surgical approach for GC remains debated, with traditional open cholecystectomy often preferred.

Purpose of the Study:

• To compare perioperative and postoperative outcomes of laparoscopic versus open cholecystectomy in patients with GC.
• To evaluate the safety and feasibility of laparoscopic surgery for GC.
• To inform surgical decision-making for GC management.

Main Methods:

• Retrospective observational study at a tertiary care center.
• Inclusion of adult patients with intraoperatively confirmed GC.
• Comparison of demographic data, operative parameters, complications, and hospital stay between laparoscopic and open cholecystectomy groups.

Main Results:

• Laparoscopic cholecystectomy had a longer mean operative time (98.5 min) than open cholecystectomy (86.2 min).
• Intraoperative complication rates were similar between groups (p=0.87).
• Laparoscopic surgery resulted in a significantly shorter median hospital stay (6 days vs. 8 days; p=0.039).

Conclusions:

• Laparoscopic cholecystectomy is a safe and feasible approach for GC.
• Despite longer operative times, laparoscopy offers benefits such as reduced hospital stay.
• A laparoscopic-first strategy with a low conversion threshold is recommended for selected GC patients.