Comparative study of morbidity of open cholecystectomy vs laparoscopic cholecystectomy in complicated gall stone disease.

Usama Shabbir, Jamal Anwar, Shahbaz Hussain, Mubashar Abrar, Ayesha Akram, Muhammad Ahsan, Ameer Afzal
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Abstract

Objective: To evaluate the resist of minimally invasive surgery i.e. laparoscopic cholecystectomy versus open cholecystectomy in cases with complex gallstone diseases. Study Design: Prospective study. Setting: North Surgical Ward, Mayo Hospital Lahore. Period: 11th July 2020 till 10th January 2021. Material & Methods: A total of 372 patient’s fulfilling the criterion was included for study in group-A Laparoscopic cholecystectomy was done. In group B open cholecystectomy was done which includes 86 patients. The entire patient received injection Ketorolac 30 mg i.e. 8 hourly and postoperative injection NeIbufin 6 mg i.v.12hourIy as standard in all patients and Post-operative pain was assessed Visual analogy scale after 24 hours. Results: The mean age of patients in open group was 41.28 ± 13.75 years and in Laparoscopic group was 43.46 ± 13.90 years. In Open group there were 80(43%) male and 106(57%) female cases while in Laparoscopic group there were 65(34.9%) male and 121(65.1%) female cases. The mean hospital stay was statistically shorter in Laparoscopic group (3.80 ± 1.37 days) as compared to Open group (5.12 ± 1.58 days), p-value <0.001. In open group 77(41.4%) cases had post-operative pain and in Laparoscopic group 27(14.5%) cases had post-operative pain. The post-operative pain was statistically higher in open groups, p-value < 0.001. Conclusion: Laparoscopic is an ideal treatment option in terms of less pain and shorter duration of hospital stay as compared to open cholecystectomy for patients with complicated gallstone disease.
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复杂胆结石症中开腹胆囊切除术与腹腔镜胆囊切除术发病率的比较研究。
目的评估微创手术(即腹腔镜胆囊切除术)与开腹胆囊切除术对复杂胆石症病例的耐受性。研究设计:前瞻性研究。研究地点拉合尔梅奥医院北外科病房。时间:2020 年 7 月 11 日至 10 日2020 年 7 月 11 日至 2021 年 1 月 10 日。材料与方法:A 组共纳入 372 名符合标准的患者进行研究,采用腹腔镜胆囊切除术。B 组包括 86 名患者,采用开腹胆囊切除术。所有患者均按标准每 8 小时注射开塞露 30 毫克,术后每 12 小时注射新布芬 6 毫克,24 小时后对术后疼痛进行视觉类比量表评估。结果:开腹组患者的平均年龄为(41.28 ± 13.75)岁,腹腔镜组患者的平均年龄为(43.46 ± 13.90)岁。开腹组中男性患者占 80 例(43%),女性患者占 106 例(57%);腹腔镜组中男性患者占 65 例(34.9%),女性患者占 121 例(65.1%)。据统计,腹腔镜组的平均住院时间(3.80 ± 1.37 天)比开腹组(5.12 ± 1.58 天)短,P 值小于 0.001。开腹组有 77 例(41.4%)术后疼痛,腹腔镜组有 27 例(14.5%)术后疼痛。据统计,开腹组的术后疼痛程度较高,P 值<0.001。结论与开腹胆囊切除术相比,腹腔镜是治疗复杂性胆石症患者的理想选择,疼痛更轻,住院时间更短。
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