Comparative study of morbidity of laparoscopic versus open cholecystectomy in complicated gallstone disease

Background: gallstone disease is a major health problem worldwide particularly in the adult population. previously complicated gallstone disease was considered to be a contraindication for laparoscopic cholecystectomy. this initial reluctance has slowly evaporated as a result of increasing expertise. the aim of study was to compare the outcome of laparoscopic with open cholecystectomy in patients with complicated gallstone disease.material & methods: this study was carried out in surgical unit-iv, liaquat university hospital jamshoro, from january 2008 to december 2009. one hundred patients were divided in two groups of 50 each; group a for open cholecystectomy (oc) and group b for laparoscopic cholecystectomy (lc). data was analyzed using spss software.results: out of 100 patients there was female preponderance with male to female ratio of 1:1.5 in group a and 1:3.5 group b. the mean age was 41.28±12.30 years for group a and 38.44±13.50 for group b. ultrasound findings revealed was single stone [13(26%) patients in oc vs 10 (20%) patients in lc group], multiple stones [37(74%) patients in oc vs 40 (48%) patients in lc group], impacted stone [15(30%) patients in oc vs 18 (36%) patients in lc group], thick wall gallbladder [26(52%) patients in oc vs 25(50%) patients in lc group], empyma [6(12%) patients in oc vs 8(16%) patients in lc group], mucocele [3(6%) patients in oc vs 5(10%) patients in lc group], contracted [7(14%) patients in oc vs 8(16%) patients in lc group]. operative time range 30 minutes to 90 minutes in both groups. the mean time in oc group was 54.90±15.90 minutes and lc group was 48.30±12.96 minutes (p 0.026). no mortality was reported in this series.conclusion: laparoscopic cholecystectomy is a safe and effective treatment of complicated gallstone disease