Research article
● Open access
Comparative Analysis of Laparoscopic and Traditional Cholecystectomy: A Comprehensive Review of Clinical Outcomes, Quality of Life, and Patient Support
Abstract
Cholecystectomy is a common surgical procedure used to treat gallstone disease. Since the introduction of laparoscopic cholecystectomy, minimally invasive techniques have largely replaced traditional open surgery due to improved clinical outcomes. This study reviews the comparative outcomes of laparoscopic and open cholecystectomy with a focus on quality of life, social support, and clinical recovery.
A systematic literature review of studies published between 2010 and 2025 was conducted using databases including PubMed, Scopus, Web of Science, and the Cochrane Library. In addition, primary data from 96 patients who underwent cholecystectomy were analyzed using the WHOQOL-BREF quality of life questionnaire and the Multidimensional Scale of Perceived Social Support (MSPSS).
Results indicate that laparoscopic cholecystectomy provides significant advantages, including reduced postoperative pain, shorter hospital stays, quicker recovery, and fewer complications compared to open surgery. Quality of life scores showed significant improvement after surgery across physical, psychological, social, and environmental domains. Social support levels also increased significantly after surgery, regardless of the surgical approach.
The findings suggest that laparoscopic cholecystectomy is the preferred treatment for symptomatic gallstone disease due to its better recovery outcomes and improved patient well-being.
Keywords
Cholecystectomy; laparoscopic surgery; open surgery; cholelithiasis; quality of life; social support; patient-reported outcomes; postoperative recovery; minimally invasive surgery; gallstone disease
References
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Bittner, R. (2020). The history of laparoscopic cholecystectomy. Journal of Minimal Access Surgery, 16(4), 315-321.
Coccolini, F., Catena, F., Pisano, M., Gheza, F., Fagiuoli, S., et al. (2021). Open versus laparoscopic cholecystectomy in acute cholecystitis: Systematic review and meta-analysis. International Journal of Surgery, 86, 32-45.
Comes, D. J., Wennmacker, S. Z., Latenstein, C. S., van der Bilt, J., Buyne, O., et al. (2024). Restrictive strategy vs usual care for cholecystectomy in patients with abdominal pain and gallstones: 5-year follow-up of the SECURE randomized clinical trial. JAMA Surgery, 159(11), 1235-1243.
Długołęcka, R., Kania, E., & Biegus, I. (2022). Opieka pielęgniarska nad pacjentem po cholecystektomii klasycznej i laparoskopowej. Pielęgniarstwo Chirurgiczne i Angiologiczne, 16(3), 85-90.
Eypasch, E., Williams, J. I., Wood-Dauphinee, S., Ure, B. M., Schmülling, C., et al. (1995). Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument. British Journal of Surgery, 82(2), 216-222.
Gach, T., Bogacki, P., Markowska, B., Bonior, J., Paplaczyk, M., et al. (2021). Quality of life of patients after laparoscopic cholecystectomy for cholelithiasis: Assessment of long-term postoperative results. Polish Journal of Surgery, 93(4), 19-24.
Ito, E., Takai, A., Imai, Y., Otani, H., Onishi, Y., et al. (2019). Quality of life after single-incision laparoscopic cholecystectomy: A randomized clinical trial. Surgery, 165(2), 353-359.
Katwal, G., Thapa, Y., Shrestha, A., Bhattarai, A., Tamrakar, K. K., et al. (2022). Open cholecystectomy among patients undergoing laparoscopic cholecystectomy in a tertiary care centre: A descriptive cross-sectional study. Journal of Nepal Medical Association, 60(249), 444-447.
Keus, F., de Jong, J. A., Gooszen, H. G., & van Laarhoven, C. J. (2021). Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database of Systematic Reviews, (3), CD006231.
Korolija, D., Sauerland, S., Wood-Dauphinee, S., Abbou, C. C., Eypasch, E., et al. (2004). Evaluation of quality of life after laparoscopic surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery. Surgical Endoscopy, 18(6), 879-897.
Kulik, J. A., & Mahler, H. I. (2022). Social support and recovery from surgery. Health Psychology Review, 16(2), 287-305.
Lammert, F., Gurusamy, K., Ko, C. W., Miquel, J. F., Méndez-Sánchez, N., et al. (2016). Gallstones. Nature Reviews Disease Primers, 2, 16024.
Lien, H. H., Huang, C. C., Wang, P. C., Huang, C. S., Chen, Y. H., et al. (2010). Changes in quality-of-life following laparoscopic cholecystectomy in adult patients with cholelithiasis. Journal of Gastrointestinal Surgery, 14(1), 126-130.
Murawa, D., & Bak, M. (2019). Współczesne techniki laparoskopowe - korzyści dla pacjenta. Ogólnopolski Przegląd Medyczny, 2, 37-43.
Patel, M., & Hugh, T. A. (2023). Comparison of three-dimensional visualization systems and two-dimensional visualization systems during laparoscopic cholecystectomy: A narrative review. Journal of Laparoendoscopic & Advanced Surgical Techniques, 33(10), 957-962.
Petryshyn, N., Drazic, T., Hogendorf, P., Strzelczyk, J., Strzałka, A., et al. (2021). Site metastases a year after initial laparoscopic cholecystectomy: Should the use of retrieval bags during laparoscopic cholecystectomy be the new gold standard? Polish Journal of Surgery, 93(4), 61-65.
Portincasa, P., Di Ciaula, A., & Wang, D. Q. (2019). Gallstones: Current and future therapeutic approaches. Expert Opinion on Pharmacotherapy, 20(13), 1611-1627.
Salati, S. A., Alfehaid, M., Alsuwaydani, S., & AlSulaim, L. (2023). Gallstones after laparoscopic cholecystectomy: A systematic review. Polish Journal of Surgery, 95(3), 56-79.
Shaffer, E. A. (2021). Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Current Gastroenterology Reports, 23(8), 11.
Shi, H. Y., Lee, H. H., Chiu, C. C., Chiu, H. C., Uen, Y. H., et al. (2008). Responsiveness and minimal clinically important differences after cholecystectomy: GIQLI versus SF-36. Journal of Gastrointestinal Surgery, 12(7), 1275-1282.
Strasberg, S. M., & Brunt, L. M. (2021). The critical view of safety: Why it is the best method to prevent bile duct injury during laparoscopic cholecystectomy. Annals of Surgery, 274(6), 919-925.
Tazuma, S. (2020). Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Practice & Research Clinical Gastroenterology, 20(6), 1075-1083.
WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551-558.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30-41.
Bektaş, M., Beşişik, S., & Gülpınar, Ö. (2022). The effect of laparoscopic cholecystectomy on body image and self-esteem. Journal of Minimal Access Surgery, 18(3), 367-373.
Bittner, R. (2020). The history of laparoscopic cholecystectomy. Journal of Minimal Access Surgery, 16(4), 315-321.
Coccolini, F., Catena, F., Pisano, M., Gheza, F., Fagiuoli, S., et al. (2021). Open versus laparoscopic cholecystectomy in acute cholecystitis: Systematic review and meta-analysis. International Journal of Surgery, 86, 32-45.
Comes, D. J., Wennmacker, S. Z., Latenstein, C. S., van der Bilt, J., Buyne, O., et al. (2024). Restrictive strategy vs usual care for cholecystectomy in patients with abdominal pain and gallstones: 5-year follow-up of the SECURE randomized clinical trial. JAMA Surgery, 159(11), 1235-1243.
Długołęcka, R., Kania, E., & Biegus, I. (2022). Opieka pielęgniarska nad pacjentem po cholecystektomii klasycznej i laparoskopowej. Pielęgniarstwo Chirurgiczne i Angiologiczne, 16(3), 85-90.
Eypasch, E., Williams, J. I., Wood-Dauphinee, S., Ure, B. M., Schmülling, C., et al. (1995). Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument. British Journal of Surgery, 82(2), 216-222.
Gach, T., Bogacki, P., Markowska, B., Bonior, J., Paplaczyk, M., et al. (2021). Quality of life of patients after laparoscopic cholecystectomy for cholelithiasis: Assessment of long-term postoperative results. Polish Journal of Surgery, 93(4), 19-24.
Ito, E., Takai, A., Imai, Y., Otani, H., Onishi, Y., et al. (2019). Quality of life after single-incision laparoscopic cholecystectomy: A randomized clinical trial. Surgery, 165(2), 353-359.
Katwal, G., Thapa, Y., Shrestha, A., Bhattarai, A., Tamrakar, K. K., et al. (2022). Open cholecystectomy among patients undergoing laparoscopic cholecystectomy in a tertiary care centre: A descriptive cross-sectional study. Journal of Nepal Medical Association, 60(249), 444-447.
Keus, F., de Jong, J. A., Gooszen, H. G., & van Laarhoven, C. J. (2021). Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database of Systematic Reviews, (3), CD006231.
Korolija, D., Sauerland, S., Wood-Dauphinee, S., Abbou, C. C., Eypasch, E., et al. (2004). Evaluation of quality of life after laparoscopic surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery. Surgical Endoscopy, 18(6), 879-897.
Kulik, J. A., & Mahler, H. I. (2022). Social support and recovery from surgery. Health Psychology Review, 16(2), 287-305.
Lammert, F., Gurusamy, K., Ko, C. W., Miquel, J. F., Méndez-Sánchez, N., et al. (2016). Gallstones. Nature Reviews Disease Primers, 2, 16024.
Lien, H. H., Huang, C. C., Wang, P. C., Huang, C. S., Chen, Y. H., et al. (2010). Changes in quality-of-life following laparoscopic cholecystectomy in adult patients with cholelithiasis. Journal of Gastrointestinal Surgery, 14(1), 126-130.
Murawa, D., & Bak, M. (2019). Współczesne techniki laparoskopowe - korzyści dla pacjenta. Ogólnopolski Przegląd Medyczny, 2, 37-43.
Patel, M., & Hugh, T. A. (2023). Comparison of three-dimensional visualization systems and two-dimensional visualization systems during laparoscopic cholecystectomy: A narrative review. Journal of Laparoendoscopic & Advanced Surgical Techniques, 33(10), 957-962.
Petryshyn, N., Drazic, T., Hogendorf, P., Strzelczyk, J., Strzałka, A., et al. (2021). Site metastases a year after initial laparoscopic cholecystectomy: Should the use of retrieval bags during laparoscopic cholecystectomy be the new gold standard? Polish Journal of Surgery, 93(4), 61-65.
Portincasa, P., Di Ciaula, A., & Wang, D. Q. (2019). Gallstones: Current and future therapeutic approaches. Expert Opinion on Pharmacotherapy, 20(13), 1611-1627.
Salati, S. A., Alfehaid, M., Alsuwaydani, S., & AlSulaim, L. (2023). Gallstones after laparoscopic cholecystectomy: A systematic review. Polish Journal of Surgery, 95(3), 56-79.
Shaffer, E. A. (2021). Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Current Gastroenterology Reports, 23(8), 11.
Shi, H. Y., Lee, H. H., Chiu, C. C., Chiu, H. C., Uen, Y. H., et al. (2008). Responsiveness and minimal clinically important differences after cholecystectomy: GIQLI versus SF-36. Journal of Gastrointestinal Surgery, 12(7), 1275-1282.
Strasberg, S. M., & Brunt, L. M. (2021). The critical view of safety: Why it is the best method to prevent bile duct injury during laparoscopic cholecystectomy. Annals of Surgery, 274(6), 919-925.
Tazuma, S. (2020). Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Practice & Research Clinical Gastroenterology, 20(6), 1075-1083.
WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551-558.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30-41.