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Comparison in Terms of Postoperative Morbidity and Hospital Stay between Open Cholecystectomy and LC
World Journal of Laparoscopic Surgery, September-December 2008;1(3):17-21
Comparison in Terms of Postoperative Morbidity

and Hospital Stay between Open Cholecystectomy

and Laparoscopic Cholecystectomy

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1 Rooh-ul-Muqim, Faryal Gul Afridi, Javeria Iqbal, Jehangir Akbar, Zahoor Khan, M Zarin
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2 Samiullah, Mohammad Aziz Wazir
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1 Assistant Professor, Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
2 Resident, Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
3 Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
4 Senior Registrar, Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
5 Professor and Incharge, Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
Correspondence: Faryal Gul Afridi, Resident Surgical D Unit, Khyber Teaching Hospital, Peshawar, Pakistan
E-mail: faryal.afridi@yahoo.com

Abstract Conclusion: Minimally invasive surgery is infact very effective in
reducing postoperative morbidity and thus hospital stay in patients
Type of study: Comparative.
with gallstones. Although open cholecystectomy is still performed in
Aim: To compare the postoperative morbidity in terms of post- our hospitals, the time is near when it will be largely replaced by the
operative pain, gait disturbances, wound and respiratory infections laparoscopic technique.
along with length of hospital stay in patients undergoing laparoscopic Keywords: Laparoscopic cholecystectomy; minimally invasive
cholecystectomy with those undergoing open surgery for symptomatic surgery; open cholecystectomy; hospital stay.
gallstone disease to compare the effectivity of minimally invasive
surgery with open surgery in reducing postoperative morbidity and INTRODUCTION
thus length of hospital stay.
Cholecystectomy is one of the most frequently performed
Place and duration of study: Surgical Unit Khyber Teaching Hospital,
Peshawar, Pakistan; from July 2006 to December 2006. operations. Open cholecystectomy (OC) has been the gold
standard for over 100 years. Laparoscopic cholecystectomy
Materials and methods: This study included a total of 50 patients (LC) was introduced in the 1980s. Since its foundation,
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who underwent either open or laparoscopic cholecystectomy in our laparoscopic cholecystectomy has become the procedure of
unit (SDW KTH). Their clinical data, admission dates and date of choice for symptomatic gallstone disease. Although both of
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surgery were noted. Postoperative progress was followed and these procedures are fairly well tolerated, wound infection
requirement of analgesia, nausea, vomiting, febrile morbidity, wound remains the most common postoperative complication which
infections and respiratory tract infections, if any were noted. Their
date of discharge from hospital was also recorded. Re-admission (if not only prolongs hospital stay, increases cost of treatment
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any) for any complication of surgery was noted and further days but can also lead to long-term complications. LC is highly
spent in hospital were recorded. This data was analyzed to see the praised and demanded by patients due to less pain, shortened
post-operative morbidity and length of hospital stay in these patients. hospital stay and diminished disability. LC abolishes the trauma
and transient ileus that follows open surgery, thus patients are
Results: Out of the 50 patients included in this study, the mean hospital free of postoperative pain and there is requirement of analgesia. 4
stay for the patients who underwent laparoscopic cholecystectomy
was 2.06 days as against 3.93 days for those having open surgery for A minimal impact on immune system, minimal exposure to exter-
symptomatic gallstone disease. Also pain (and thus analgesia nal environment, carbon dioxide pneumoperitoneum, better
requirement) and other complications were significantly lower for the visualization of tissues for dissection and hemostasis reduces
patients who had minimally invasive surgery indicating the superiority the frequency of infections and other morbidity in patients
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of laparoscopic technique as regards postoperative hospital stay and undergoing LC. Thus, aim of this study was to observe and
morbidity. compare the postoperative morbidity in terms of pain, GI upsets,

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