Open versus Endoscopic Approach in Gall Bladder Surgery

Endoscopic Approach

• The laparoscopic Cholecystectomy has clearly replaced open surgery. This technique became gradually over the years the gold standard procedure.
• It avoids big incisions which means no risk of incisional hernias, less pain, recovery time is shorter, in short time back to work and daily activity, cosmetically better, advantageous for obese patients and as a keyhole surgery.
• The patient will be either on the same day discharged or on the next day. The role of Laparoscopic Cholecystectomy in the treatment of acute cholecystitis is still to some surgeons controversial.

Open Approach

Open surgery is nevertheless always an option if laparoscopic surgery cannot be done safely for example because of unclear anatomy due to peritonitis caused by perforation or sometimes there are complications related to access to the abdominal cavity, cardiovascular or respiratory diseases. This will necessitate the conversion to open surgery. It is not a technical failure if a surgeon decides to convert to open surgery.

On the contrary, it is better to decide earlier than later to minimize the risk of complications. The laparoscopic surgery takes about 30-40 minutes and the open surgery takes about 60-75 minutes

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