A Comparative Analysis between Laparoscopic and Open Cholecystectomy at a Tertiary Care Hospital in Patients with Acute Cholecystitis

Background: Acute cholecystitis is clinically characterized as an episode of acute biliary pain; fever and right hypochondrial tenderness with symptoms persistence exceeding 24 hours. Aims & Objectives: We compared and analyzed open and laparoscopic cholecystectomy in the current study on the basis of the duration of the operation, intra and postoperative complications and the length of hospital stay & return to work.Material and Methods: This was a prospective comparative, randomized hospital-based study performed in patients of 20 - 80 years of age with acute cholecystitis in the Department of General Surgery from July 2019 to January 2021 at SMHR length of hospital stay and wound infection, return to work. The gathered data was statistically analyzed. Results: In both categories, the most common age group was 40-59 years old. The female population (78%) was greater than the male population (22 percent). 1: 3.6 was the male to female ratio. The mean time needed for open cholecystectomy was 53.18 ± 12.74 minutes, while 38.37 ± 6.21 minutes for laparoscopic cholecystectomy, and the difference was statistically important. 2 (3.3 percent) laparoscopic procedures involved conversion to open surgery due to difficult dissection, bleeding & blurred vision. In terms of postoperative pain (VAS > 4), hospital stay period and return to work, laparoscopic cholecystectomy had better outcomes than open cholecystectomy and the difference was statistically important. In Open Cholecystectomy patients, wound infection, post-operative paralytic ileus was substantially greater. There were 2 patients with wound dehiscence from open cholecystectomy. No significant morbidity or any mortality during the study period was reported.Conclusion: Laparoscopic cholecystectomy provides decisive advantages over open cholecystectomy in acute cholecystitis (e.g. shorter time of surgery, fewer post-operative complications, less paralytic ileus, less analgesic use, early discharge and mobilization).