Laparoscopic versus open cholecystectomy in patients with gallstone disease admitted to Aden public hospitals, Yemen

ABSTRACT

Gallstone disease is a common surgical pathology and major cause of morbidity. In Yemen-Aden, remote studies confirmed the high incidence of gallstone disease. To compare both procedures by age, sex, risk factors, operation length, morbidity, postoperative pain and hospital stay. To identify risk factors for intra-operative conversion and post-operative morbidity. This is a prospective and observational comparison between open cholecystectomy [OC] and laparoscopic cholecystectomy [LC] in symptomatic gallstone patients, conducted in Aden hospitals, between Jan 2004 to Dec 2005. Cholecystectomy were performed in 116 patients. Fifty had OC and 66 LC. Males were 8 and females were 108 Male to female ratio was 1 9 and mean age 45.6 years. Operation time was 85 minutes for OC and 80 LC. Intraoperative complications were statistically significant in LC while postoperative morbidity was not significant [11.7% LC Vs 8.0% OC]. Conversion rate for LC was 9.1%. In LC, age of 60 and acute cholecystitis were statistically related to postoperative morbidity. Significant mild postoperative pain was found in LC and severe pain OC. Mean hospital stay was shorter with LC group. LC is a safe technique with better postoperative hospital stay and less pain, without difference in operative characteristics, morbidity and mortality. Despite early experience in LC, the acceptable conversion rate and morbidity are good initial outcome measures. We recommend training programs in laparoscopic surgery and establishment of a well equiped diagnostic and therapeutic endoscopic unit