Assessment of Surgical Outcome From Laparoscopic Versus Open Cholecystectomy During 1st Week of Acute Cholecystitis

Abstract

Background: Acute Calcular Cholecystitis (A.C) is inflammation of the gallbladder and is the most common complication of gallstones, requiring hospital admission and prompt intervention. Its Symptoms include right upper abdominal pain, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis without appropriate treatment, recurrent episodes of cholecystitis are common. Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, and inflammation of the common bile duct. Aim of The Work: To assess surgical outcome from laparscopic and open cholecystectomy in acute calcular cholecystitis by assessment and differentiate between both of them in these parameters as regards: 1-Hospital stay, 2-Wound infection, 3-Bilary fistula, 4-Missed stone, 5-intestinal injury. Patients and Methods: Type of Study: prospective clinical trial. Study Setting: This study will be carried out, at Ain Shams hospitals. Study Period: This study will be carried out during the period between October2018 and October 2019. Study Population: This study will include 30 patients with diagnosis of acute calcularcholycystitis. Results: The present study was a prospective, clinical, trial that included30 patients diagnosed with acute calcular cholecystitis attended to surgery theatre at Ain Shams hospital. The patients were divided into two groups: Group I including 15 patients underwent laparoscopic cholecystectomy during the first week of their presentation. Group II including 15 patients underwent open cholecystectomy during the first week of their presentation. Conclusion: Cholecystectomy during 1st week of acute cholecystitis should be attempted by laparoscopy at first in condition that there are no complications as gangerenous gall bladder. as, postoperative morbidity and hospital stay are reduced by laparoscopic cholecystectomy. Moreover, intestinal injury and wound infection rate are reduced by laparoscopy. A positive trend exists in operating time favoring laparoscopy, however more studies are necessary. Severe hemorrhage and bile leakage rate are not influenced by the technique.

Open Versus Laparoscopic Cholecystectomy in Acute Cholecystitis: A Systematic Review

“…Laparoscopic cholecystectomy has surpassed open cholecystectomy as the preferable method for cholecystectomy. 8,9 Prior to 1991, the standard procedure for cholecystectomy was the open method. However, current research indicates that laparoscopic cholecystectomy is the most common surgical treatment for acute cholecystitis.11,12 There are no additional studies that compare open cholecystectomy and laparoscopic cholecystectomy in terms of complications, duration of hospital stay, disadvantages, and advantages.…”