A comparative study between open and laparoscopic cholecystectomy in K.A.P. Viswanatham Government Medical College, Trichy

INTRODUCTION: Laparoscopic cholecystectomy is removal of the gallbladder through small incision made in the abdomen, about 500000 minimally invasive cholecystectomy has been performed throughout the world annually. Laparoscopic cholecystectomy is the procedure of choice for asymptomatic and symptomatic gall bladder disease. Professor Muhe of Boblingen, Germany performed the first laparoscopic cholecystectomy on September 12, 1985. He used a side viewing endoscope with an instrumentation channel inserted through the umbilicus after creating pneumoperitoneum using a Veress needle. HISTORY OF OPEN CHOLECYSTECTOMY: The history of gall bladder surgery starts with Jean Louis Petit over 250 yrs ago (1674- 1750). He performed puncture and removal of the gall bladder stones. First choledocholithotomy was performed by Ludwig George Courvoisier (1890). First elective cholecystostomy was performed by John Stough Bobbs in Indianapolis for hydrops of gall bladder. Carl Langenbuch performed the first cholecystectomy in Berlin. AIM OF THE STUDY: The aim of this study is to compare laparoscopic cholecystectomy with that of open cholecystectomy by the factors of 1. technique of surgery, 2. duration of surgery, 3. post operative morbidity, 4. analgesic requirement, 5. antibiotic requirement, 6. post operative hospital stay, 7. complications, 8. duration for normal diet, 9. duration for return to normal activity 10. cosmetic effect of laparoscopic surgery over open surgery. MATERIALS AND METHODS: In our KAPV Govt medical college hospital we are performing both laparoscopic and open cholecystectomy. This study is conducted between Jan 2012- Dec 2013. This study is a comparative study. I have selected 25 cases in laparoscopic cholecystectomy and 25 cases in open cholecystectomy and compared both. The indications are cholelithiasis, chronic calculous cholecystitis, biliary colic, acute cholecystitis and acalculous cholecystitis. CONCLUSION: In our study laparoscopic cholecystectomy succeeded the open procedure by the following: 1. Better visualisation and magnification of anatomy of Callots triangle. 2. Reduced post operative morbidity. 3. Shorter duration of requirement of analgesia. 4. Shorter duration of requirement of antibiotics. 5. Reduced wound infection. 6. Early resumption of normal diet. 7. Early ambulation and return to normal activity. 8. Shorter post-operative stay in hospital. 9. Best cosmetic effect. The only disadvantage of laparoscopic procedure is increased time duration