Background: Appendectomy is most common surgical procedure done for treatment of acute appendicitis. Both laparoscopic and open techniques are used for its removal. The aim of this study is to compare the outcome of laparoscopic appendectomy with open appendectomy. Materials and Methods: A retrospective study was conducted in Nobel Medical College And Teaching Hospital, Biratnagar, Nepal from April 2019 to February 2021.Total 90 patients were enrolled in the study of which 44 in laparoscopic appendectomy group and 46 in open appendectomy group. These two groups were compared for demographic profiles, operative time, postoperative pain, length of hospital stay and surgical site infections. Results: Ninety patients underwent appendectomy of which 44 were in Laparoscopic group and 46 in Open group with similar demographic profiles. The mean operative time in Laparoscopic group was 42.95±2.46 minutes where as in Open group it was 35.25±1.87 minutes [p<0.001].The mean postoperative pain at 8 hours in Laparoscopic group was 7.77±1.03 and in Open group 8.45±1.16 [p=0.002], at day one Laparoscopic group 5.01±0.88 and in Open group 5.80±0.99 [p<0.001],at day two Laparoscopic group 3.54 ±1.19 and in Open group 4.26±0.89[p<0.001]. Mean duration of hospital stay in Laparoscopic group was 2.02±0.26 and Open group was 2.52 ±0.54[p<0.001]. Surgical site infections was noted 1(2.27%) in Laparoscopic group and 6(13.04%) in Open group[p=0.029]. Conclusion: Laparoscopic appendectomy offers less postoperative pain, shorter hospital stay, less surgical site infections but prolonged operative time compared to open appendectomy.
Background: Laparoscopic Cholecystectomy is considered as a gold standard treatment for symptomatic cholelithiasis. The timing of surgery for acute Cholecystitis is still controversial, weather to go early surgery or wait for six to eight weeks after conservative management. Therefore, the aim of this study is to compare the clinical outcomes of early versus delayed laparoscopic cholecystectomy for acute Cholecystitis. Materials and Methods: A prospective study was conducted in Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Total of 80 patients with the diagnosis of acute Cholecystitis were enrolled in the study. The patients were equally divided in two groups: 40 underwent early laparoscopic cholecystectomy within 72 hours of admission (Group A) and next 40 underwent delayed laparoscopic cholecystectomy after 6-8 weeks of conservative management (Group B). Results: Out of 80 patients of acute Cholecystitis, mean age of the patients in Group A was 43.40±13.45 years and that in Group B was 44.80±14.36 years. The mean operative time in Group A was 90.22±2.81 minutes whereas in Group B it was 80.97±4.47 minutes. Mean duration of Hospital stay in Group A was 2.02±0.15 days whereas in Group B it was 2.15±0.36 days. Two patients in Group A and one patient in Group B converted to open cholecystectomy. Three patients of Group A and one patient of Group B landed in outpatient department with superficial surgical site infection. Group B patients underwent second hospital admission compared to Group A patients. Conclusion: Early Laparoscopic cholecystectomy for acute cholecystitis is almost comparable with delayedLaparoscopic cholecystectomy. However, early laparoscopic cholecystectomy reduces the morbidity of patients as well as it is cost-effectiveness.
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