Comparative Analysis of Early Clinical Outcomes in Patients Experience Open vs. Laparoscopic Cholecystectomy
Laparoscopic vs. Open Cholecystectomy Outcomes
DOI:
https://doi.org/10.69750/dmls.01.09.069Keywords:
Laparoscopic cholecystectomy, Open cholecystectomy, Acute cholecystitis, Early intervention, Postoperative complications, Recovery outcomes, Elderly patients, Hospital stayAbstract
Background:
Laparoscopic cholecystectomy (LC) has largely replaced open cholecystectomy (OC) for acute cholecystitis due to its minimally invasive nature. However, the impact of surgical timing (early vs. delayed) and outcomes in elderly patients remains unclear.
Objective:
To compare clinical safety, complications, and recovery outcomes of LC and OC, with a focus on age-related differences and surgical timing.
Methods:
A prospective cross-sectional study was conducted on 500 patients with acute cholecystitis. Patients were stratified into LC (n=300) and OC (n=200) groups. Subgroup analysis was performed for younger (<60 years) and elderly (≥60 years) patients, as well as early (<7 days) and delayed (>6 weeks) LC. Key outcomes included hospital stay duration, complications (wound infections, bile duct injury), and biomarker changes (CRP, WBC). Data were analyzed using SPSS v29.0, with p<0.05 considered significant.
Results:
LC resulted in shorter hospital stays (3.2 ± 1.5 days vs. 8.4 ± 2.0 days; p<0.001) and fewer wound infections (5.6% vs. 13.5%; p=0.008) compared to OC. Conversion to OC occurred in 10.3% of LC cases due to severe adhesions. Elderly patients had higher complication rates (19.8% vs. 8.4%; p=0.012). Early LC showed fewer complications (8.4% vs. 16.2%; p=0.002) and faster inflammatory resolution (CRP reduction; p<0.001).
Conclusion:
LC is superior to OC in terms of recovery and safety, particularly with early intervention. Elderly patients require careful evaluation of comorbidities to minimize complications.
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Hania B, Ahmad Z, Zafar A, Riaz D, Jawad A, Sahar DE. A comparative study of postoperative outcomes: open cholecystectomy versus laparoscopic cholecystectomy: evaluating postoperative outcomes in gallbladder surgery. Dev Med Life Sci. 2024;1(5):27-34. doi:10.69750/dmls.01.05.053
Siddiqui T, MacDonald A, Chong PS, Jenkins JT. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195(1):40-7. doi:10.1016/j.amjsurg.2007.03.004
Wong A, Burstow MJ, Yuide PJ, Naidu S, Lancashire RP, Chua TC. Comparative analysis of models of care and its impact on emergency cholecystectomy outcomes. J Laparoendosc Adv Surg Tech. 2022;32(7):756-62. doi:10.1089/lap.2021.0588
de Mestral C, Rotstein OD, Laupacis A, Hoch JS, Zagorski B, Alali AS, et al. Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis. Ann Surg. 2014;259(1):10-5. doi:10.1097/SLA.0b013e3182a5cf36
Zhao JJ, Syn NL, Chong C, Tan HL, Ng JYX, Yap A, et al. Comparative outcomes of needlescopic, single-incision laparoscopic, standard laparoscopic, mini-laparotomy, and open cholecystectomy: a systematic review and network meta-analysis. Surgery. 2021;170(4):994-1003. doi:10.1016/j.surg.2021.04.004
Shi Z. Laparoscopic vs open surgery: a comparative analysis of wound infection rates and recovery outcomes. Int Wound J. 2024;21(3):e14474. doi:10.1111/iwj.14474
Cremer K, Kloppenberg FWH, Vanhommerig JW, Dijksman LM, Bode N, Donkervoort SC. Effect of surgical strategy in difficult cholecystectomy cases on postoperative complications: a value-based healthcare comparative study. Surg Endosc. 2022;36(7):5293-302. doi:10.1007/s00464-021-08907-y
Coccolini F, Solaini L, Binda C, Catena F, Chiarugi M, Fabbri C, et al. Laparoscopic cholecystectomy in acute cholecystitis: refining best surgical timing through network meta-analysis. Surg Laparosc Endosc Percutan Tech. 2022;32(6):755-63. doi:10.1097/SLE.0000000000001103
Grossman H, Holder KG, Freedle C, Dhanasekara CS, Dissanaike S. Comparing outcomes of subtotal cholecystectomy versus open cholecystectomy as bailout procedures for the difficult gallbladder. Am Surg. 2023;89(12):5372-8. doi:10.1177/00031348221148345
Feng X, Cao JS, Chen MY, Zhang B, Juengpanich S, Hu JH, et al. Laparoscopic surgery for early gallbladder carcinoma: a systematic review and meta-analysis. World J Clin Cases. 2020;8(6):1074-86. doi:10.12998/wjcc.v8.i6.1074
Wu H, Liao B, Cao T, Ji T, Huang J, Luo Y, et al. Comparison of safety profile, conversion rate and hospitalization duration between early and delayed laparoscopic cholecystectomy for acute cholecystitis: systematic review and meta-analysis. Front Med. 2023;10:1185482. doi:10.3389/fmed.2023.1185482
Keeratibharat N, Patcharanarumol S, Puranapanya S, Phupaibul S, Khomweerawong N, Chansangrat J. Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand. Ann Hepatobiliary Pancreat Surg. 2024;28(3):381-7. doi:10.14701/ahbps.24-056
Handler C, Kaplan U, Hershko D, Abu-Hatoum O, Kopelman D. High recurrence of gallstone-related episodes following acute cholecystitis in patients not receiving surgery: a retrospective comparative study. Eur J Trauma Emerg Surg. 2023;49(2):1157-61. doi:10.1007/s00068-022-02106-7
Tauriainen A, Biancari F, Tauriainen T. Comparative analysis of 3-D vs 2-D imaging in laparoscopic cholecystectomy. World J Surg. 2021;45(5):1. doi:10.1007/s00268-020-05934-z
Mannam R, Sankara Narayanan R, Bansal A, Yanamaladoddi VR, Sarvepalli SS, Vemula SL, et al. Laparoscopic versus open cholecystectomy in acute cholecystitis: a literature review. Cureus. 2023;15(9):e45704. doi:10.7759/cureus.45704
Kamarajah SK, Karri S, Bundred JR, Evans RPT, Lin A, Kew T, et al. Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: systematic review and meta-analysis. Surg Endosc. 2020;34(11):4727-40. doi:10.1007/s00464-020-07805-z
Goel A, Kothari S, Bansal R. Early vs late laparoscopic cholecystectomy after ERCP for choledocholithiasis. Euroasian J Hepatogastroenterol. 2021;11(1):11-3. doi:10.5005/jp-journals-10018-1338
Rifai AO, Rembetski EM, Stutts LC, Mazurek ZD, Yeh JL, Rifai K, et al. Operative time and discharge time: laparoscopic vs robotic cholecystectomy and appendectomy. J Robot Surg. 2023;17(5):2187-93. doi:10.1007/s11701-023-01632-9
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