COMPARISON OF SMALL-INCISION OPEN CHOLECYSTECTOMY VERSUS LAPAROSCOPIC CHOLECYSTECTOMY FOR PATIENTS WITH SYMPTOMATIC CHOLELITHIASIS

ABSTRACT
Objective: To compare the complications and symptomatic relief of the laparoscopic cholecystectomy (LC) with the
small incision cholecystectomy (SIC) in patients with symptomatic Cholelithiasis.
Material and Methods: This comparative study was conducted in the Surgical Department of Peshawar Institute of
Medical Sciences Hayatabad Peshawar from January 2014 to December 2014 total numbers of 157 patients, aged
between 18-60 years, having symptomatic gallstones were enrolled from the Out Patients Department using purposive
convenient sampling. Operation, anesthesia, analgesics and postoperative care were standardized and both Laparoscopic
cholecystectomy (LC) and small incision cholecystectomy (SIC) were performed by the same group of surgeons.
Complications and symptom relief were primary outcome measures, operative time and hospital stay were secondary
outcome measures. The patients were followed up on 2 weeks, and 6 weeks postoperatively.
Results: Out of 157 patients, 80 underwent SIC and 77 underwent LC. Both groups were matched for age, gender,
BMI, clinical findings and ASA grading. The mean duration of operation was 44 and 62 minutes in the SIC and LC
groups, respectively (p = 0.000). LC was found to have shorter duration of hospital stay and return to regular activities
as compared to SIC. Pain scores were the same in both groups while intra-operative and post-operative complications
were slightly greater in LC group as compared to SIC group.
Conclusion: SIC is comparable to LC in terms of complication rate and symptomatic relief. It offers a good alternative
in areas where LC facility or expertize is not available.
Key words: Cholelithiasis, Laparoscopic cholecystectomy, Small incision cholecystectomy, Common Bile Duct.