SHORT-TERM OUTCOMES OF CLASSICAL VS MINI LAPAROTOMY CHOLECYSTECTOMY FOR SYMPTOMATIC GALLSTONE DISEASE

Abstract

Background: Gallstone disease is one of the most common surgical conditions worldwide, traditionally managed by open cholecystectomy. With advancements in surgical techniques, mini laparotomy cholecystectomy has emerged as a less invasive alternative that may shorten hospital stay and enhance recovery without compromising safety. Objective: To compare the discharge criteria of patients undergoing classical versus mini laparotomy cholecystectomy within 48 hours of surgery. Study Design: Randomized Controlled Trial. Setting: Department of General Surgery, Mercy Teaching Hospital, Peshawar, Pakistan. Duration of Study: From 05-12-2024 to 05-05-2025. Methods: Ninety-four patients with symptomatic gallstones were enrolled and randomly assigned to two groups. Group A (n=47) underwent mini cholecystectomy through a 3–5 cm subcostal incision, while Group B (n=47) underwent classical cholecystectomy through an 8–12 cm incision. The primary outcome was the proportion of patients fulfilling discharge criteria within 48 hours postoperatively, defined as tolerating oral intake, passing stools, having no respiratory issues, a clean wound, no further need for analgesia, and full mobility. Data were analyzed using SPSS version 20, and statistical significance was set at p < 0.05. Results: The demographic characteristics were comparable between the two groups. A significantly higher proportion of patients in the mini cholecystectomy group (83.0%) met all discharge criteria within 48 hours compared to the classical cholecystectomy group (61.7%) (p = 0.02). The mean postoperative hospital stay was significantly shorter in the mini cholecystectomy group (1.91 ± 0.69 days) than in the classical cholecystectomy group (2.45 ± 0.88 days). Conclusion: Mini laparotomy cholecystectomy demonstrated superior short-term outcomes compared to classical laparotomy, with earlier fulfillment of discharge criteria and shorter hospital stays. It represents a safe and effective alternative for the management of symptomatic gallstones, particularly in resource-limited settings.