Which Is More Effective: Laparoscopic or Open Partial Cholecystectomy?

Abstract

Objective: In laparoscopic cholecystectomy, partial cholecystectomy is usually preferred when the anatomic exploration is not enough to prevent bile duct injury and other complications. Some surgeons choose laparoscopically to perform partial cholecystectomy, whereas others convert to open surgery. In this study, we aim to discuss and compare the effectiveness of laparoscopic partial cholecystectomy (LPC) and open partial cholecystectomy (OPC). Materials and Methods: The data of 4712 patients who underwent laparoscopic cholecystectomy between 2012 and 2020 were reviewed. A total of 98 patients who had partial cholecystectomy were included in the study. Patients were examined in two groups according to whether the procedure was open or laparoscopic. The first group of patients was named the OPC group (n\u2009=\u200952), and the second group of patients was the LPC group (n\u2009=\u200946). The data of the two groups were comparatively analyzed. Results: The mean operative time and the postoperative hospital stay, respectively, were 118.2 minutes and 4.8 days in the OPC group, and 87.3 minutes and 2.55 days in the LPC group (P\u2009<\u2009.005 and P\u2009=\u2009.005). It was found that wound infection decreased by 83.1% (P\u2009=\u2009.026; odds ratio [OR]\u2009=\u20090.169) in the LPC group compared with the OPC group, and the probability of developing incisional hernia decreased by 81.1% (P\u2009=\u2009.014; OR\u2009=\u20090.189). At least one complication was observed in 17 patients in the OPC group and in 7 patients in the LPC group (P\u2009=\u2009.045). The probability of developing complications in any patient was 63% lower in the LPC group (P\u2009=\u2009.049; OR\u2009=\u20090.370). Conclusions: The indications that cause the surgeon to perform partial cholecystectomy are inherently open to complications, regardless of the surgical technique used. However, the laparoscopic operation has advantages such as shorter operation time, shorter postoperative hospital stay, lower risk of wound infection and incisional hernia rate, and lower complication rate than the open procedure. However, if the team performing the surgery does not have enough experience, they should never hesitate to switch to open cholecystectomy.