Open Cholecystectomy vs Laparoscopic Cholecystectomy

Cholecystectomy or gallbladder surgery was once the most common treatment for gallstones. Originally, in order to remove the gallbladder, surgeons had to perform open cholecystectomy by making incision on right upper abdominal about 20 cm lenght. A risky open surgery that required at least a week long hospital stay and a month long recovery period.



Later, advances in medicine allowed surgeons to do laparoscopic cholecystectomy. In this procedure, the surgeon makes tiny incisions in your abdomen and inserts a small camera and cutting tools. So that the result is earlier return of bowel function, less postoperative pain, improved cosmesis, shorter length of hospital stay, earlier return to full activity, and decreased overall cost. While this surgery is safer than open cholecystectomies, it still carries the risk of internal bleeding.

Today, gallbladder surgery is seen as a last resort. The gallbladder is an important organ. Without it, the liver will drip bile directly onto the small intestine. This usually results in chronic diarrhea and irritable bowel syndrome, requiring life-long changes in diet.

Also, gallbladder surgery does not prevent new gallstones from forming. Even after gallbladder removal, gallstones can still form in the bile ducts. In fact, 40% of patients who have undergone gallbladder removal report continuing gallstone attacks years after their surgery!

See indications and contraindications on Laparoscopic Cholecystectomy used by surgeon to perform surgical procedure below :

Indications for LC :

Symptomatic cholelithiasis

Biliary colic
Acute cholecystitis
Gallstone pancreatitis
Asymptomatic cholelithiasis

Sickle cell disease
Total parenteral nutrition
Chronic immunosuppression
No immediate access to health care facilities (e.g., missionaries, military personnel, peace corps workers, relief workers)
Incidental cholecystectomy for patients undergoing procedure for other indications
Acalculous cholecystitis (biliary dyskinesia)
Gallbladder polyps >1 cm in diameter
Porcelain gallbladder
Contraindication :

Absolute

Unable to tolerate general anesthesia
Refractory coagulopathy
Suspicion of gallbladder carcinoma
Relative

Previous upper abdominal surgery
Cholangitis
Diffuse peritonitis
Cirrhosis and/or portal hypertension
Chronic obstructive pulmonary disease
Cholecystoenteric fistula
Morbid obesity
Pregnancy