Comparison of Day Case Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy

Abstract

Objective: To compare the day case Laparoscopic cholecystectomy with conventional Laparoscopic cholecystectomy in terms of early return to activities and intensity of postoperative pain. Study Design: Randomized control trial (Parallel). Place and Duration of Study: Department of Surgery Pakistan Institute of Medical Sciences/ Shaheed Zulfiqar Ali Bhutto Medical University Islamabad. Study was conducted from 1 Nov 2014 to 30 April 2015. Materials and Methods: After approval of hospital ethical committee, patients who were fulfilling the inclusion criteria were included in study after taking informed and written consent. Sample size was calculated using WHO sample size calculator, which turned out to be 42 for each group. Patients were divided into two groups, group A and group B by lottery method. Patients in group A had undergone Day case Laparoscopic cholecystectomy and patients in group B had undergone Conventional Laparoscopic cholecystectomy. Data was collected and recorded on purposively designed Performa. Data was analyzed using SPSS 17; paired t test was used to calculate p-value. Results: In group A, among 42 patients 13(31%) were on VAS 4, 13(31%), on VAS 5, 8(19%), in VAS 3, 6(14.3%), in VAS 2 and 2(4.8%), in VAS 6. The minimum and maximum “number of days to return to activities” was 3 and 7 days respectively. Among 42 patients, 20(47.6%) patients had returned to their home activities in 3 days, 13(31%) in 4 days, 5(11.9%) in 5 days, 2(4.8%) in 6 days and 2(4.8%) in 7 days. In group B the minimum and maximum intensity of pain on Visual Analogue Scale was 2 and 6 respectively. Among 42 patients 15(35.7%) were on VAS 5, 14(33.3%) were on VAS 3, 8(19%), in VAS 4, 4(9.5%), in VAS 6 and 1(2.4%), in VAS 2. The minimum and maximum “number of days to return to activities” was 6 and 10 days respectively. Out of 42 patients 17(40.5%) had returned to their home activities in 9 days, 17(40.5%) in 8 days, 4(9.5%) in 7 days, 3(7.1%) in 10 days and 1(2.4%) in 6 days. Conclusion: Patients undergoing day case LC do return to their routine activities earlier than those who undergo conventional LC, but there is no difference in terms of intensity of post-operative pain as measured on Visual analogue scale.

Keywords

• cholelithiasis, day case surgery, laparoscopic, day case laparoscopic cholecystectomy, laparoscopic cholecystectomy.