Laparoscopic versus open cholecystectomy: complications and cost

Abstract

Purpose: Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones. The aim of the study was to analyze and compare the postoperative results of patients undergoing laparoscopic cholecystectomy or open cholecystectomy (OC) with regard to complications, recovery time, hospital stay and cost. Method: This is a prospective study, which analyzed 1015 patients, 20-65 years old, diagnosed with gallstones undergoing LC or OC. We evaluated postoperative respiratory complications, surgical site infection, deep vein thrombosis, time to oral feeding and ambulation, use of antibiotics, duration of the postoperative period and the cost of surgery. Results: We analyzed 470 (46%) patients undergoing LC and 545 (54%) OC. Most patients were female (68,4%). Patients' comorbidities were hypertension (15.8%), diabetes mellitus (4.0%) and asthma (1.18%). LC resulted in lower prevalence of postoperative complications (2.9%) than OC (5.13%). Postoperative hospitalization for 18-24 hours was found in 71.68% of LC patients and in 13.4% in OC. The financial cost per surgery was US$ 495.00 in LC and US$ 435.00 in OC. Conclusion: Laparoscopic cholecystectomy showed higher benefits for patients with lower prevalence of postoperative complications, feeding earlier, shorter mean hospital stay and equivalent cost compared with open cholecystectomy.