International Journal of Scientific and Research Publications, Volume 5, Issue 6, June 2015 1 ISSN 2250-3153 www.ijsrp.org Comparison of Patient Response to Laparoscopic versus Open Cholecystectomy: A study From A Rural Center in India Somendra Pal Singh, Prashant Gupta, Anil Kumar Sharma, Manjaree Mishra, Praveen Singh, Shashi Prakash Mishra Assistant Professor, Department of Surgery, UPRIMS&R, Saifai, Etawah (U.P.), India. 206130 Abstract- Introduction- Laparoscopic cholecystectomy is now gold standard for the treatment of gall stone diseases. Studies have compared various parameters to prove it superiority over open cholecystectomy. Aim- The aim of this study was to prove the superiority of any of the two procedures over the other in terms of above parameters in our patients from rural background. Materials and Methods- The study included 81 patients which were randomized in two groups; A- Laparoscopic B- Open Cholecystectomy group. Observations and Results- We observed a statistically significant difference between the two groups in terms of high level of CRP post operatively, average VAS score on post operative day 1 and 2 and the incidence of surgical site infections. Conclusion- The results of this study supports that Laparoscopic cholecystectomy appears to consist the merits to be the gold standard procedure for symptomatic gall stone diseases in rural population as well. Index Terms- Laparoscopic, Open, Cholecystectomy, CRP, VAS, SSI I. INTRODUCTION he invention of laparoscopic surgery has definitely brought a paradigm shift in the traditional surgical practice. This is rather a new way of thinking and has motivated surgeons to think of doing possibly every operation by a minimally invasive way. History of first cholecystectomy dates back to 1882, when Carl Langebuch of Germany performed the first cholecystectomy [1]. Prof Dr Erich Mühe of Germany performed the first laparoscopic cholecystectomy (LC) in 1985. [1] The first laparoscopic cholecystectomy in India was performed in 1990 at the JJ Hospital, Mumbai, followed a few months later in Pune by Dr. Jyotsna Kulkarni. [2]. Laparoscopic cholecystectomy (LC) is now the gold standard treatment of symptomatic gallstones and the indications for laparoscopic cholecystectomy are same as that of open cholecystectomy.[3] Various workers in randomized control trials have claimed laparoscopic cholecystectomy to be better as compared with the open technique due to earlier return of bowel motility, less post-operative pain, better cosmetic result and shorter hospital stay resulting in equal or lower hospital costs, as documented by various. [4-7] There have been many studies which have compared both the procedures in term of hospitalization, analgesia required; sick leave, stress response etc and results have been varied. [4] We did a randomized control trial to evaluate the response of our patients (which are mainly from rural background) to laparoscopic versus open cholecystectomy to ascertain that laparoscopic cholecystectomy possesses the capability of being more an acceptable procedure than open; in our patients as well. II. AIM The current study has compared the response of our patients to laparoscopic versus open cholecystectomy in terms of percentage change in total leukocyte count (preoperative to post operative), post operative serum level of C Reactive Proteins, post operative ultrasound abdomen, pain as measured on Visual Analogue Scale after 24 hrs and 48 hrs of surgery and surgical site infections up to the end of one week of surgery. Thus the aim of this study was to prove the superiority of any of the two procedures over the other in terms of above parameters in our patients. III. MATERIALS AND METHODS This study was performed in a Rural Post Graduate Institute of Medical Science & Research in North India. The study was approved from the Institutional Ethical Committee. The diagnosed gall stone patients been admitted to a single unit in Surgery department of Institute for elective cholecystectomy between January 2013 to January 2015, were included in the study. The exclusion criteria being patients more than 60 years of age, having higher ASA grades (≥3), patients having diabetes mellitus and/or diagnosed cardiac illness and patients unwilling to participate in the study. A detailed history and clinical examination of all the patients was done and all the patients were investigated as per protocol. Patients were randomized in two groups according to their will after explaining the procedures and study to be done. Group A was having patients undergoing elective laparoscopic cholecystectomy and Group B having patients undergoing elective open cholecystectomy. The patients were operated by any of surgeons from a single surgical unit as per the availability. All the patients in both the groups received single shot of Inj. Ceftriaxone 1 gram I.V. after sensitivity test, at the time of induction of anesthesia. T