ORIGINAL ARTICLE
Open Access

Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy

Irakli Giorgadze, Mariam Kharshiladze, Giorgi BakradzeORCID 1

¹ Department of General Surgery, Tbilisi State University Hospital, Tbilisi, Georgia.

DOI: 10.18081/ajbm.2025.4.311

Publication History: Received 03 August 2025, Revised 11 September 2025, Accepted 19 October 2025, Available online 04 November 2025
Copyright: © 2025 Bakradze, et al. This is an open-access article under a Creative Commons license (CC BY 4.0).
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ABSTRACT

Background

Cholecystectomy remains one of the most frequently performed abdominal surgeries worldwide. The introduction of laparoscopic cholecystectomy (LC) has revolutionized biliary surgery, offering reduced postoperative morbidity and faster recovery compared with the traditional open approach. However, outcome variations across different healthcare systems—particularly in transitional economies such as Georgia—necessitate continued comparative evaluation.

Objective
To compare postoperative outcomes between laparoscopic and open cholecystectomy (OC) in patients with symptomatic gallstone disease at a tertiary teaching hospital in Georgia.

Methods

This prospective comparative study was conducted at Tbilisi State University Hospital between January 2023 and December 2024, enrolling 200 patients with symptomatic cholelithiasis who underwent elective cholecystectomy—100 laparoscopic and 100 open. Exclusion criteria included acute cholecystitis, choledocholithiasis, and previous upper abdominal surgery. Standardized perioperative and postoperative care protocols were applied. Data were analyzed using SPSS v26.0. Continuous variables were compared using the independent t test and categorical data with the Chi-square test; P < 0.05 was considered statistically significant.

Results

Baseline demographics were comparable between the two groups. The mean operative time was slightly longer for LC (62.3 ± 14.5 min) than OC (56.8 ± 11.7 min; P = 0.067). LC patients experienced significantly less postoperative pain (VAS 24h: 2.4 ± 0.9 vs. 5.2 ± 1.1; P < 0.001) and fewer wound infections (2% vs. 9%; P = 0.028). Mean hospital stay was markedly shorter in the LC group (1.8 ± 0.7 days) compared to the OC group (5.4 ± 1.2 days; P < 0.001). Patients resumed normal activity earlier following LC (6.2 ± 2.1 days vs. 13.8 ± 3.3 days; P < 0.001). Multivariate regression identified open surgery, ASA ≥ III, and age >50 years as independent predictors of postoperative complications (P < 0.05). No mortality or major bile duct injury occurred.

Conclusion

Laparoscopic cholecystectomy provides superior postoperative outcomes compared with the open technique, including significantly lower pain intensity, fewer wound infections, shorter hospitalization, and faster recovery. These findings validate LC as the gold standard for elective gallbladder surgery and support its broader adoption across Georgian and regional healthcare systems. Expansion of laparoscopic infrastructure, standardized training, and national clinical guidelines are recommended to ensure safe, equitable access to minimally invasive surgery.

Keywords: Laparoscopic cholecystectomy; Open cholecystectomy; Postoperative outcomes; Wound infection; Hospital stays

Recommended Citation

Giorgadze I, Kharshiladze M, Bakradze G. Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy. Advanced Journal of Biomedicine & Medicine. 2025;13(4):311-329. doi:10.18081/ajbm.2025.4.311

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze (2025). Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy. American Journal of Biomedicine, 13(4), 311-329. https://doi.org/10.18081/ajbm.2025.4.311
Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze. "Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy." American Journal of Biomedicine, vol. 13, no. 4, 2025, pp. 311-329. DOI: 10.18081/ajbm.2025.4.311.
Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze. Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy. Am J Biomed. 2025;13(4):311-329. DOI: 10.18081/ajbm.2025.4.311. PMID: .
Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze 2025, "Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy", American Journal of Biomedicine, vol. 13, no. 4, pp. 311-329.
@article{irakli2025, title={Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy}, author={Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze}, journal={American Journal of Biomedicine}, volume={13}, number={4}, pages={311-329}, year={2025}, doi={10.18081/ajbm.2025.4.311} }
TY - JOUR AU - Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze TI - Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy JO - American Journal of Biomedicine VL - 13 IS - 4 SP - 311-329 PY - 2025 DO - 10.18081/ajbm.2025.4.311 ER -
%0 Journal Article %A Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze %T Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy %J American Journal of Biomedicine %V 13 %N 4 %P 311-329 %D 2025 %R 10.18081/ajbm.2025.4.311 %M
Irakli Giorgadze, Mariam Kharshiladze, Giorgi Bakradze (2025). Evaluating the Impact of Surgical Technique on Postoperative Outcomes: Laparoscopic Versus Open Cholecystectomy. American Journal of Biomedicine, 13(4), 311-329. https://doi.org/10.18081/ajbm.2025.4.311

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