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Laparoscopic versus open cholecystectomy: a matched study

J R Sanabria1, P A Clavien, R Cywes

  • 1Department of Surgery, Mount Sinai Hospital, University of Toronto, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|August 1, 1993
PubMed
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Laparoscopic cholecystectomy (LC) significantly reduces hospital stays and recovery times for gallstone disease compared to open cholecystectomy (OC). This minimally invasive approach offers comparable safety with improved patient outcomes and reduced costs.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Gallstone disease management has evolved with surgical techniques.
  • Open cholecystectomy (OC) was the traditional standard for gallstone removal.
  • The introduction of laparoscopic cholecystectomy (LC) aimed to improve patient recovery.

Purpose of the Study:

  • To evaluate the efficacy of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) for gallstone disease.
  • To compare patient outcomes, including hospitalization and return to work, between OC and LC.
  • To assess complications, costs, and patient satisfaction associated with both surgical methods.

Main Methods:

  • A comparative study of 121 patients per period over three years (1989-1991).

Related Experiment Videos

  • Period 1: Open cholecystectomy (OC) only.
  • Periods 2 & 3: Increasing adoption of laparoscopic cholecystectomy (LC), with Period 3 using LC as the primary treatment.

    • Main Results:

    • LC significantly reduced length of hospitalization (2.4 days) and return to work (1.3 weeks) compared to OC (6.4 days, 5.8 weeks).
    • Postoperative complications were not significantly different in frequency but were less severe with OC.
    • Operative time for LC initially increased but normalized; 5% of LC cases required conversion to OC.

    Conclusions:

    • Laparoscopic cholecystectomy (LC) offers significant benefits for gallstone disease treatment.
    • Shorter hospital stays, faster recovery, reduced costs, and high patient satisfaction are key advantages of LC.
    • LC demonstrates a favorable safety profile with very low morbidity and mortality.