A comparison of incidents and complications among patients who underwent laparoscopic vs open cholecystectomy

Introduction: Cholecystectomy, the surgical removal of the gallbladder, is common for gallstone disease. Laparoscopic cholecystectomy (LC) is favoured for its benefits over open cholecystectomy (OC). This study compares incidents and complications between the two approaches at the Surgical Professorial Unit, Teaching Hospital Karapitiya.
Methods: A comparative cross-sectional study evaluated incidents and complications in LC versus OC patients from 2015 to 2023. Altogether 302 patients were sampled, meeting specific criteria, with data collected retrospectively and analysed statistically.
Results: Of the 302 patients, 70.5% (n=213) had LC and 29.5% (n=89) had OC. Haemorrhage was common in OC (3.6% vs. 2.6%), while gallbladder perforation occurred more in LC (7.3% vs. 0.7%). Challenges in identifying Calot’s triangle were more frequent in LC (4.3% vs. 0.3%). Postoperatively, LC patients had shorter hospital stays (1.32 vs. 3.52 median days). Cardiac complications were common, while surgical site infections were more prevalent in OC. (2.3% vs 0.9%). Presence of comorbidities like diabetes (p=0.04) and ischaemic heart disease (p=0.037) correlated with postoperative complications significantly. Mortality rates were higher   in OC (2.2% vs. 0.4%). Conversion to OC from LC was zero.
Conclusions: LC is preferred method for cholecystitis due to its advantages over OC, including shorter hospital stays, and fewer complications. Higher efficacy of LC in managing comorbidities and its safety, with no conversions to OC, supports its recommendation as the treatment of choice for cholecystitis patients, particularly those with underlying health conditions.