A Comparative Clinical Study of Laparoscopic Versus Open Cholecystectomy in The Management of Gall Bladder Disease

Cholelithiasis is a common biliary pathology, with laparoscopic cholecystectomy (LC) now considered the standard of care. In its early adoption in India, it faced challenges including equipment cost, surgical learning curves and intraoperative complications. Some of these points are relevant even today. This study aimed to compare the outcomes of LC and open cholecystectomy (OC) based on various parameters and also to compare the data with the present day clinical practise. retrospective analysis was conducted on 100 patients (50 LC, 50 OC) undergoing cholecystectomy at a tertiary hospital in Mumbai. Patients were included regardless of comorbidities, with exclusion criteria including choledocholithiasis and gallbladder carcinoma. Cases requiring conversion from LC to OC were noted. Key parameters included postoperative complications, duration of hospital stay, time to oral intake, and cosmesis. Data were statistically analysed using t-tests and a p-values <0.05 were considered significant. The conversion rate from LC to OC was 22%, primarily due to bleeding and technical difficulty. Mean hospital stay was significantly shorter for LC (6.34±4.29 days) vs OC (9.94±4.65 days) (p<0.05). Complications like vomiting, fever and wound infection were lower in the LC group, though not statistically significant. Cosmetic satisfaction was higher in the LC group. Intraoperative complications, notably CBD injury, were more frequent in LC. However, more recent studies showed lower conversion rate and intraoperative complications in LC. The intraoperative risks and complications associated with LC appear to have declined significantly over the period of time due to increased surgical expertise.whereas LC has always showed faster recovery and improved cosmesis. While surgical expertise significantly influences LC outcomes, making it a preferred option, OC may remain a relevant option in resource-limited settings due to other parameters.