Laparoscopic versus open cholecystectomy in acute cholecystitis: a systematic review
Laparoscopic versus open cholecystectomy in acute cholecystitis: a systematic review
DOI:
https://doi.org/10.51473/rcmos.v1i1.2025.914Keywords:
Cholecystectomy. Acute cholecystitis. Laparoscopic surgery. Open surgery. Surgical complications.Abstract
To evaluate, through systematic review, the available evidence comparing laparoscopic and open cholecystectomy in the management of acute cholecystitis, focusing on complications, hospital stay, conversion rate, and mortality. Following PRISMA guidelines, studies from 2018 to 2024 were selected in PubMed, Randomized clinical trials, systematic reviews, comparative observational studies, and meta-analyses were included. Key outcomes were operative time, complications, hospital stay, conversion rate, and mortality. Seventeen studies were included. Laparoscopic cholecystectomy was associated with shorter hospital stays, faster recovery, and lower surgical site infection rates. Open cholecystectomy, on the other hand, was favored in severe inflammation, distorted anatomy, or intraoperative complications. Laparoscopic surgery is the preferred approach in most cases of acute cholecystitis due to lower morbidity and faster recovery. The open approach remains relevant in high-risk orcomplex situations.
Downloads
References
ALIUS, C. et al. When Critical View of Safety fails: a practical perspective on difficult laparoscopic cholecystectomy. Medicina (Kaunas), v. 59, n. 8, p. 1491, 2023. DOI: https://doi.org/10.3390/medicina59081491
CIROCCHI, R. et al. Management of acute cholecystitis in high-risk patients: percutaneous gallbladder drainage as a definitive treatment vs. emergency cholecystectomy—systematic review and meta-analysis. Journal of Clinical Medicine, v. 12, n. 15, p. 4903, 2023. DOI: https://doi.org/10.3390/jcm12154903
FINCO, T. et al. Laparoscopic cholecystectomy improves outcomes in cirrhotic patients with acute cholecystitis. Journal of Hepatobiliary Pancreatic Sciences, v. 29, n. 3, p. 338–348, 2022. DOI: https://doi.org/10.1002/jhbp.852
HASSLER, K. R. et al. Laparoscopic cholecystectomy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025.
ISEDA, N. et al. Textbook outcome in the laparoscopic cholecystectomy of acute cholecystitis. Asian Journal of Endoscopic Surgery, v. 16, n. 4, p. 741–746, 2023. DOI: https://doi.org/10.1111/ases.13238
KOSTENBAUER, J. K. et al. Factors affecting early cholecystectomy for acute cholecystitis in older people—a population-based study. World Journal of Surgery, v. 47, n. 7, p. 1704–1710, 2023. DOI: https://doi.org/10.1007/s00268-023-06968-9
KUMAR, S. S. et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surgical Endoscopy, v. 38, n. 6, p. 2947–2963, 2024. DOI: https://doi.org/10.1007/s00464-024-10810-1
MANNAM, R. et al. Laparoscopic cholecystectomy versus open cholecystectomy in acute cholecystitis: a literature review. Cureus, v. 15, n. 9, e45704, 2023. DOI: https://doi.org/10.7759/cureus.45704
MEMIŞOĞLU, E.; SARİ, R. Timing of cholecystectomy in recurrent attacks of acute cholecystitis. Ulus Travma Acil Cerrahi Derg, v. 28, n. 4, p. 508–512, 2022. DOI: https://doi.org/10.14744/tjtes.2022.81908
MONTENEGRO, D. M. et al. The safety of minimally invasive and open cholecystectomy in elderly patients with acute cholecystitis: a systematic review. Cureus, v. 14, n. 11, e31170, 2022. DOI: https://doi.org/10.7759/cureus.31170
NASSAR, A. et al. Outcome of early cholecystectomy compared to percutaneous drainage of gallbladder and delayed cholecystectomy for patients with acute cholecystitis: systematic review and meta-analysis. HPB (Oxford), v. 24, n. 10, p. 1622–1633, 2022. DOI: https://doi.org/10.1016/j.hpb.2022.04.010
PAGE, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, v. 372, n. 71, p. n71, 2021. DOI: https://doi.org/10.1136/bmj.n71
RAMÍREZ-GIRALDO, C. et al. Subtotal laparoscopic cholecystectomy versus conversion to open as a bailout procedure: a cohort study. Surgical Endoscopy, v. 38, n. 9, p. 4965–4975, 2024. DOI: https://doi.org/10.1007/s00464-024-10911-x
SEERAS, K. et al. Bile duct repair. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025.
SESHADRI, A.; PEITZMAN, A. B. The difficult cholecystectomy: what you need to know. Journal of Trauma and Acute Care Surgery, v. 97, n. 3, p. 325–336, 2024. DOI: https://doi.org/10.1097/TA.0000000000004337
TARTAGLIA, D. et al. Laparoscopic cholecystectomy for acute calculous cholecystitis in elderly: more complex but equally safe and effective. Annali Italiani di Chirurgia, v. 93, p. 550–556, 2022.
VARGHEESE, S. et al. Laparoscopic cholecystectomy in acute calculous cholecystitis: a secondary center experience. Cureus, v. 15, n. 6, e41114, 2023. DOI: https://doi.org/10.7759/cureus.41114
WARCHAŁOWSKI, Ł. et al. The analysis of risk factors in the conversion from laparoscopic to open cholecystectomy. International Journal of Environmental Research and Public Health, v. 17, n. 20, p. 7571, 2020. DOI: https://doi.org/10.3390/ijerph17207571
Downloads
Additional Files
Published
Issue
Section
Categories
License
Copyright (c) 2025 Letícia Meneses Teixeira, Matheus Andrade Gonçalves, Enzo Galinari Magalhães de Moura Faria, Vinícius Alves Barbosa (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This means you are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The use of this material is conditioned upon proper attribution to the original author(s), providing a link to the license, and indicating if changes were made. The license does not require permission from the author or the publisher as long as these conditions are met.
The Creative Commons license logo is displayed permanently in the footer of the journal.
The copyright of the manuscript can be retained by the authors without restrictions and can be requested at any time, even after publication in the journal.
