• Kiran Siddiqui
  • Abul Fazal Ali Khan


Background: The objective of this quasi experimental study was to compare the frequency ofwound infection between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC)conducted in Surgical Unit IV, Jinnah Hospital Lahore from June 2005 to January 2006.Methods: 100 patients undergoing elective cholecystectomy for symptomatic gallstones werestudied. The patients were allocated in the two groups of 50 each by simple random technique.Group-I underwent OC and Group-II underwent LC. The patients were then followed up for fourweeks to pick up signs of wound infection. In case of infection, the degree of infection and theremedial measures done were documented and the results analysed. Results: In LC group therewas only one case of Class- II wound infection i.e. 2%. In case of OC there were three cases ofwound infection i.e. 6%. Out of these, two were of Class-III and one of Class-II. Conclusion:While there was no wound infection in cases of chronic Cholecystitis in both groups, thefrequency of wound infection was three times as common in OC as compared to LC in AcuteCholecystitis / Empyema.Key words: Open cholecystectomy (OC), Laparoscopic Cholecystectomy (LC), Wound infection.


Abbasi SA, Haleem A, Tariq GR, Iqbal A, Almas D, et al.

An audit of laparoscopic cholecystectomies performed at

PNS Shifa. Pak Armed Forces Med 2003;53: 51-8.

Javaid I, Bashir A, Qamar I. Laparoscopic V/S open

cholecystectomy morbidity comparison. Prof. Med J 2002; 9:


Cheema AM, Akif M, Mohammad Z. An experience of

laparoscopic cholecystemies at Lahore General Hospital.

Biomedica 2001; 17: 32-6.

Arian GM, Randhawa H, Malik SA. Laparoscopic

cholecystectomy and its complications: A study of 1100

cases. Pak J Gasteroenterol 1998; 12 : 29-35.

Lennard TWJ, Shenton BK, Borzotta A. The influence of

surgical operations on components of the human immune

system. Br J Surg 1985; 72: 771-6.

Targarona EM, Balague C, Knook M. M. Laparoscopic

surgery and surgical infection. Br J Surg 2000; 87: 536-44.

Vittimberga FJ, Foley DP, Meyers WC. Laparoscopic

surgery and the systemic immune response. Ann Surg 1998;

: 326-34.

Hackan DJ, Rostein OD. Host response to laparoscopic

surgery: mechanisms and clinical correlates. Can J Surg

; 41: 103-11.

Sietses C, Beelen RH, Meijer S, Cuesta MA. Immunological

consequences of laparoscopic surgery, speculations on the

cause and clinical implications. Langenbeckes Arch Surg

; 384:250-8.

Carey PD, Wakefield CH, Thayeb A, Monson JR, Darzi

Guillou PJ. Effects of minimially invasive surgery on

hypochlorous acid production by neutrophils. Br J Surg 1994;


Gal L, Lanios L, Roth E. Changes in PMN-elastase and Creactive protein following traditional and laparoscopic

cholecystectomy. Surg Endose 1996; 10:552.

Redmond HP, Waston RWG, Houghton T. Immune function

in patients undergoing open vs laparoscopic

cholecystectomy. Arch Surg 1994; 129:1240-6.

Iwanaka T, Arkovitz MS, Ary G. Evaluation of operative

stress and peritoneal macrophage function in minimally

invasive operations. J Am Coll Surg 1997; 184:357-63.

Jacobi CA, Ordermann J, Zieren HU, Volk T. The impact of

laparoscopy with carbon dioxide versus helium on local and

systemic inflammation in an animal model of peritonitis.

Surg Endosc 1998; 12:480.

Watson RWG, Redmond HP, McCarthy J, Barke PE.

Exposure of the peritoneal cavity to air regulates early

inflammatory responses to surgery in a animal model. Br J

Surg 1998; 82: 1060-5.

The Southern Surgeons Club. A prospective analysis of 1518

laparoscopic cholecystemies. N Engl J Med 1991; 324: 1073-

Gold – Deutch R, Mashiach R, Boldar I, Fersztm. How dose

infected bile effect the postoperative course of patients

undergoing laparoscopic cholecystectomy? Am J Surg 1996;

: 272-4.

Targarona EM, Garau J, Munoz-Ramos C, Roster F. Single

doze antibiotic prophylaxis in patients high risk for infection

in biliary surgery: a prospective and randomized study

comparing cefonicid with mezlocilin. Surgery 1990; 107:


Song F, Glenny AM. Antimicrobial prophylaxis in colorectal

surgery; a systematic review of randomized controlled trials.

Br J Surg 1998; 85: 1232-41.

Frantzides CT, Sykes A. A revaluation of antibiotic

prophylaxis in laparoscopic cholecystectomy. J

Laparoendosc Surg 1994; 4: 375-8.

Champault G, Taffinder G, Ziol M, Riskalla H, Catheline

JMC. Cells are present in the smoke created during

laparoscopic surgery, Br J Surg 1997; 84:993-5.

Kazemier G, Hazebrock E, Branderburg A, Bonjer HJ. Filters

can help to prevent patient-to-patient transmission of viruses

and bacteria during laparoscopic surgery. Surg Endosc 1998;

: 81.

Fox JC, Duncan T, Ramshaw B, Tucker JG. Laparoscopic in

the evaluation and treatment of patients with AIDS and acute

abdominal complaints. Surg Endosc 1997; 11: 1026-8.

Dehni N, Kazatchkine M, Fernandez F. Role of laparoscopic

surgery in the management of acute abdomen in the HIV –

positive patient. J Laparoendosc Surg 1995; 5: 101-4.

Tanner AG, Hartley JE, Darzi A, Rosin RD. Laparoscopic

surgery in patients with human immunodeficiency virus. Br J

Surg 1994: 81: 1647-8.