COMPARATIVE ANALYSIS OF LAPAROSCOPIC VERSUS OPEN CHOLECYSTECTOMY IN PATIENTS WITH CHOLECYSTOLITHIASIS: A RETROSPECTIVE STUDY FROM THE CLINICAL HOSPITAL OF TETOVA

Abstract

Background: Cholecystolithiasis is one of the most common gastrointestinal disorders requiring surgical intervention worldwide. Since its introduction in the late 1980s, laparoscopic cholecystectomy (LC) has progressively replaced the conventional open approach (OC) as the standard treatment for symptomatic gallstone disease, although the open technique remains relevant in selected clinical situations. Aim: To analyze the demographic profile, comorbidity burden, and perioperative outcomes of patients operated for cholecystolithiasis at the Clinical Hospital of Tetova, and to compare postoperative complications and length of hospitalization between LC and OC. Materials and Methods: A retrospective observational study was carried out at the Department of Surgery of the Clinical Hospital of Tetova, in collaboration with the Faculty of Medical Sciences, University of Tetova. Sixty- four consecutive adult patients operated for symptomatic cholecystolithiasis were included. Demographic data, comorbidities, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status classification, surgical technique, postoperative complications, and length of hospital stay were extracted and analyzed. Results: The cohort comprised 48 women (75%) and 16 men (25%), aged 23 to 72 years. Forty-six patients (71.9%) underwent LC and 18 (28.1%) underwent OC. Arterial hypertension was present in 48 patients (75%) and diabetes mellitus in 32 (50%). Approximately 70% of patients had a BMI between 28 and 30 kg/m2. ASA classification revealed 44 patients (68.75%) in class I, 16 (25%) in class II, and 4 (6.25%) in class III. Postoperative complications—wound infection, wound bleeding, and prolonged postoperative pain—were more frequent among patients operated by the open technique. Length of hospital stay was substantially shorter in the laparoscopic group. Conclusion: Laparoscopic cholecystectomy was associated with fewer postoperative complications and shorter hospitalization compared with the open approach, supporting its role as the preferred method for symptomatic cholecystolithiasis. Careful preoperative evaluation of comorbidities and ASA status remains essential for optimal outcomes.