Prospective analysis of 192 consecutive cholecystectomies: a comparative study between laparoscopy and laparotomy

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Cholecystectomy is a common surgical procedure for biliary symptoms.
• Laparoscopic cholecystectomy (LC) emerged as an alternative to traditional laparotomy.
• Assessing the comparative efficacy and safety of LC versus laparotomy is crucial.

Purpose of the Study:

• To prospectively analyze and compare the outcomes of laparoscopic cholecystectomy and laparotomy.
• To evaluate operative time, hospital stay, cost, and morbidity for both procedures.
• To determine the suitability of LC for various indications of cholecystectomy.

Main Methods:

• Prospective analysis of hospital records for 192 patients undergoing cholecystectomy between October 1990 and March 1993.
• Categorization of patients by surgical indication: uncomplicated gallstones, common bile duct stones, and cholecystitis.
• Comparison of laparoscopic cholecystectomy (n=133 attempted, 127 successful) with laparotomy.

Main Results:

• Laparoscopic cholecystectomy demonstrated significantly shorter operative times (88 min vs. 132 min) and hospital stays (5 days vs. 13 days) compared to laparotomy (p < 0.001).
• LC was associated with reduced hospitalization costs (103,301 BF vs. 186,931 BF) (p < 0.001).
• Perioperative morbidity rates were equivalent between the two surgical approaches, regardless of the indication for cholecystectomy.

Conclusions:

• Laparoscopic cholecystectomy provides significant benefits in terms of efficiency and cost-effectiveness compared to laparotomy.
• The advantages of LC were observed across all studied indications for cholecystectomy.
• With increasing surgical experience and improved instrumentation, LC can be recommended for the majority of patients requiring cholecystectomy.