Title: Clinical Study of Complications of Laparoscopic Cholecystectomy and Open Cholecystectomy
Authors: Dr Jitendra Sankpal, Dr Shekhar Jadhav, Dr Mukund Tayade, Dr Yogesh Torkadi, Sushrut Sankpal, Dr Shubham Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.40
This is clinical study of 440 patients undergoing elective laparoscopic and open cholecystectomy in a tertiary care hospital during the period from June 2013 to June 2016. Out of the 440 patients, 50% underwent laparoscopic surgery and 50% open cholecystectomy. The incidence of gall bladder disease was highest in the age group of 41-50 years, showing incidence of 33 %. The mean age incidence in present study was 44.71 years. Incidence of Complication was also highest in age group 41-50 yrs. Majority patients were females, which were found to be 282 patients, while male were 158 patients. Ratio of male to female was 1: 1.78. Complication rate in male and female was 10.12% and 9.21% respectively. Male and females had no significant statistical difference for the incidence of complications in both Laparoscopic and open cholecystectomy groups. Pre operative ultrasonographic finding of gall bladder wall thickness > 3mm was associated with an increased risk of complication and conversion of laparoscopic cholecystectomy to open cholecystectomy. Obesity [BMI > 30 kg/m2] and acute cholecystitis was associated with increased risk of complication as well as conversion. The mean operating time increased in the cases which complicated intraoperatively. Complication rate among both groups in Laparoscopic and open cholecystectomy was 8.18 % and 10.9% respectively. Thus there was no significant difference in the incidence of complications. Spillage of gall stone was most common complication in laparoscopic cholecystectomy followed by intraoperative gall bladder perforation and biliary duct injury. Whereas following open cholecystectomy, post operative wound infection was the most common complication, followed by post operative bile leakage. Complication rate among both study groups was similar but, intra operative morbidity and severity of complications was more in laparoscopic cholecystectomy. 1. Navez B, Mutter D, Russier Y, et al. Safety of laparoscopic approach for acute cholecystitis: retrospective study of 609 cases. World J Surg. 2001;25:1352–6. 2. Clavien P, Sanabria J, Strasberg S. Proposed classification of complication of surgery with examples of utility in cholecystectomy. Surgery. 1992;111:518–526. 3. Bektas H, Schrem H, Winny M, Klempnauer JSurgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems.Br J Surg. 2007 Sep; 94(9):1119-27. 4. Bansal A, Akhtar M, Bansal AK. A clinical study: prevalence and management of cholelithiasis. IntSurg J. 2014; 1(3): 134-139. 5. Hussain A1, Mahmood HK, Duluk K.Laparoscopic cholecystectomy can be safely performed in a resource-limited setting: the first 49 laparoscopic cholecystectomies in Yemen.JSLS. 2008 Jan-Mar;12(1):71-6 6. C Palanivelu, KalpeshJani, and Gobi S. Maheshkumar.Single-Center Experience of Laparoscopic Cholecystectomy Journal of Laparoendoscopic& Advanced Surgical Techniques. October 2007, 17(5): 608-614 7. Kimura K et al. Prospective study of laparoscopic cholecystectomy in two hundred and fifty patients. Endoscopy 1992;24(9)740-4 8. Leon Morgenstern AD, Wong L, Berci G: Twelve hundred open cholecystectomies before the laparoscpic era. A standard for comparison. Arch Surg 1992;127:400-403. 9. Liu C.L., Fan S.T., Lai E.C.S., et al. — Factors affecting conversion of laparoscopic cholecystectomy to open surgery. Arch Surg. 131:98–101, 1996 10. Rosen M., Brody F., Ponsky J. — Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg. 184:254–258, 2002. 11. Majeski J1 Significance of preoperative ultrasound measurement of gallbladder wall thickness.Am Surg. 2007 Sep;73(9): 926-9. 12. Jagdish Nachnani, AvinashSupe. Preope-rative prediction of difficult laparoscopic cholecystectomy using clinical and ultra-sonographic parameters. Indian journal of gastroenterology , 2005: 24:16-18. 13. Al Salamah SM. Outcome of laparoscopic cholecystectomy in acute cholecystitis. J Coll Physicians Surg Pak 2005; 15: 400-3. 14. Kum CK, Goh PMY, Issaac JR, Tekant Y, NgoiSS.Laparoscopic Cholecystectomy for acute cholecystitis. Br JSurg 1994; 81: 1651-1654. 15. Jatzko G, Lisborg PH, Perti AM, et al. Multivariate comparison of complications after laparoscopic cholecystomy and open cholecystectomy. Arm Surg.1995;221: 381–6. 16. Buanes T, Mjaland O. Complications in laparoscopic and open cholecystectomy: A prospective trial. SurgLaparoscEndosc 1996;6(4):226-272. 17. Jan YY, Chen MF. Laparoscopic versus open cholecystectomy a prospective randomized study. J Formos Med Assoc1993;92(Suppl 4):5243-5249.Abstract
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