open vs lap choly

Q: Laparoscopic cholecystectomy is preferred over open cholecystectomy due to lower rate of overall serious complication rates?

A) True

B) False

Answer: B

Laparoscopic cholecystectomy, popularly known as "lap chole," is considered the "gold standard" for gallstones requiring surgical intervention due to various advantages, such as less postoperative pain, aesthetically appealing, shorter length of stay, and less disability off days from work. However, the overall serious complication rate in laparoscopic cholecystectomy is higher than in open cholecystectomy. 

It should be accepted that this inference on higher complications is biased for two reasons. First, open cholecystectomy is now reserved only for complicated and challenging cases, and less open cholecystectomies are performed nowadays. Second, if lap-choly requires conversion to open-choly in OR, it results in severe complications, with worst injuries to bile duct, hepatic artery, or portal vein - and all this goes under the banner of lap-chole!!

#surgical-critical-care

#hepatology

#procedures

References:

1. Khan MH, Howard TJ, Fogel EL, et al. Frequency of biliary complications after laparoscopic cholecystectomy detected by ERCP: experience at a large tertiary referral center. Gastrointest Endosc 2007; 65:247.

2. Hogan NM, Dorcaratto D, Hogan AM, et al. Iatrogenic common bile duct injuries: Increasing complexity in the laparoscopic era: A prospective cohort study. Int J Surg 2016; 33 Pt A:151.

3. Visser BC, Parks RW, Garden OJ. Open cholecystectomy in the laparoendoscopic era. Am J Surg 2008; 195:108.