A prospective comparative study on laparoscopic cholecystectomy vs open cholecystectomy

Srinath, R (2018) A prospective comparative study on laparoscopic cholecystectomy vs open cholecystectomy. Masters thesis, Thanjavur Medical College, Thanjavur.

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Abstract

INTRODUCTION: Gall stone disease is common in India, that too affecting mostly middle age group men and women. The classical open cholecystectomy and the minimally invasive laparoscopic cholecystectomy are two alternative operations for removal of the gallbladder. There are no significant differences in mortality and complications between the laparoscopic and the open techniques. The laparoscopic operation has advantages over the open operation regarding duration of hospital stay and convalescence. With the advent of laparoscopic cholecystectomy the scenario of surgical management of cholelithiasis has changed drastically. It has opened new horizons in the management of gallstones. Theoretical benefits of laparoscopic approach include reduced hospitalization and cost, decreased pain, avoidance of large incision with improved cosmetic purpose and reduced post-operative recovery time with an early return to work. AIM OF THE STUDY: 1. To compare time taken for surgery. 2. To compare and discuss the various operative complications in both the surgery. 3. To compare the postoperative complications. 4. To compare postoperative hospital stay. 5. To compare pain duration in both surgeries. MATERIALS AND METHODS: My study is a prospective randomized study included 88 patients with gallstones, who were admitted to Thanjavur medical college and hospital from September 2016 to September 2017. The selection of procedure of open cholecystectomy or laparoscopic was decided depending up on the inclusion and exclusion criteria, exception when patient consent was not given for a particular procedure. Information was collected from the patients after a written valid informed consent from them. The study was approved by IEC. Patients between 20 years to 60 years with acute cholecystitis, or chronic cholecystitis and gall stones without pain abdomen, were included in the study. Patient’s written valid informed consent for the particular procedure was taken. Patients less than 20 years and more than 60 years or those with Gall bladder cancer and Choledocholithiasis were excluded. This study involved preoperative assessment, intraoperative practice and post-operative management and follow up till 3 months. All the patients were studied with reference to duration of surgery, post-operative analgesia, post-operative stay and morbidity, intra operative and post-operative complications. CONCLUSION: Minimally invasive surgery is better than open cholecystectomy in terms of postoperative pain, analgesic requirement, early return to work. However open cholecystectomy is preferred method for surgeons in beginning of their career and in case of difficult dissection and bleeding.

Item Type: Thesis (Masters)
Uncontrolled Keywords: laparoscopic cholecystectomy ; open cholecystectomy ; prospective comparative study.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 06 Aug 2018 02:21
Last Modified: 06 Aug 2018 02:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/9107

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