Comparative Analysis of Laparoscopic Versus Open Cholecystectomy in Acute Cholecystitis: A Prospective Observational Study

Abstract

Background: A laparoscopic or open cholecystectomy (OC) is the standard treatment for acute cholecystitis, a common surgical emergency. Although laparoscopic cholecystectomy (LC) has become the standard surgical procedure for elective cases, research is currently ongoing to determine the safety and effectiveness of LC and OC procedures for treating acute cholecystitis, particularly in settings with limited resources.

Objective: To compare the perioperative and postoperative outcomes of patients undergoing laparoscopic and open cholecystectomy for acute cholecystitis.

Methods: This prospective observational study was conducted at Shaikh Zayed Hospital, Lahore from December 1, 2024 to May 31, 2025. 110 patients with acute cholecystitis were included in total; there were an equal number of patients in each group, 55 of whom received LC and 55 of whom received the OC treatment. The following information was gathered: hospital stay, recovery status, clinical presentation, operative time, intraoperative and postoperative problems, and demographics. SPSS version 26.0 was used for the statistical analysis, and a p-value of less than 0.05 was deemed significant.

Results: In comparison to the OC group (58.2 ± 12.8 min; p < 0.001), the LC group's mean operating time was much greater (72.6 ± 15.4 min). However, LC was linked to an earlier return to regular activities (5.6 ± 2.3 vs. 10.4 ± 3.1 days; p < 0.001) and a considerably shorter hospital stay (2.8 ± 1.2 vs. 5.3 ± 1.5 days; p < 0.001).

Conclusion: Laparoscopic cholecystectomy offers better clinical outcomes than open surgery in acute cholecystitis and should be considered the preferred approach when feasible.