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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References
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. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 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. The American Journal of Surgery. 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. Journal of Laparoendoscopic & Advanced Surgical Techniques. 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. Annals of Surgery. 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 of 96 randomized controlled trials with 11,083 patients. 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. International Wound Journal. 2024;21(3):e14474.doi: 10.1111/iwj.14474
Cremer K, Kloppenberg FWH, Vanhommerig JW, Dijksman LM, Bode N, Donkervoort SC. The effect of surgical strategy in difficult cholecystectomy cases on postoperative complications outcome: a value-based healthcare comparative study. Surgical Endoscopy. 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 the Best Surgical Timing Through Network Meta-Analysis of Randomized Trials. Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2022;32(6):755-63.doi: 10.1097/sle.0000000000001103
Grossman H, Holder KG, Freedle C, Dhanasekara CS, Dissanaike S. Comparing Outcomes of Sub-Total Cholecystectomy Versus Open Cholecystectomy as Bailout Procedures for the Difficult Gallbladder. The American Surgeon™. 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 the safety profile, conversion rate and hospitalization duration between early and delayed laparoscopic cholecystectomy for acute cholecystitis: a systematic review and meta-analysis. Frontiers in Medicine. 2023;10.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: Assessing effectiveness and safety with a propensity score matched analysis. ahbps. 2024;28(3):381-7.doi: 10.14701/ahbps.24-056
Handler C, Kaplan U, Hershko D, Abu-Hatoum O, Kopelman D. High rates of recurrence of gallstone associated episodes following acute cholecystitis during long term follow-up: a retrospective comparative study of patients who did not receive surgery. European Journal of Trauma and Emergency Surgery. 2023;49(2):1157-61.doi: 10.1007/s00068-022-02106-7
Tauriainen A, Biancari F, Tauriainen T. Comparative Analysis of Three-Versus Two-dimensional Imaging in Laparoscopic Cholecystectomy. World Journal of Surgery. 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 Cholecystectomy 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: a systematic review and meta-analysis. Surgical Endoscopy. 2020;34(11):4727-40.doi: 10.1007/s00464-020-07805-z
Goel A, Kothari S, Bansal R. Comparative Analysis of Early versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreaticography in Cases of Cholelithiasis with 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. Retrospective analysis of operative time and time to discharge for laparoscopic vs robotic approaches to appendectomy and cholecystectomy. Journal of Robotic Surgery. 2023;17(5):2187-93.doi: 10.1007/s11701-023-01632-9
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