Background: To study the efficacy of closed and open methods for creating
pneumoperitoneum in
laparoscopic cholecystectomy by comparing the two in terms of their outcome and complication. Study Design: Single-centre, prospective, observational study. Materials and study: Purposive sampling method where the inclusion criteria were all patients with
cholelithiasis who were advised and consented to
laparoscopic cholecystectomy of age 18-70 years were included in the study group. Exclusion criteria include patients with a paraumbilical
hernia, a history of upper abdominal surgery, uncontrolled systemic illness, and local skin
infection. Sixty cases of
cholelithiasis satisfying exclusion and inclusion criteria who underwent elective
cholecystectomy during the study period were included. Thirty-one of these cases underwent the closed method, while in the remaining 29 patients open method was adopted. Cases in which
pneumoperitoneum created by closed technique were grouped as group A and those by open technique as group B. Parameters comparing the safety and efficacy of the two methods were studied. The parameters were access time, gas leak, visceral
injury, vascular injury, need for conversion, umbilical port site
hematoma, umbilical port site
infection, and
hernia. Patients were assessed on the first postoperative day, the seventh postoperative day, and then two months after surgery. Some follow-ups were done telephonically. Results: Out of 60 patients, 31 underwent the closed method, while 29 underwent the open method. Minor complications like gas leak during the procedure was observed more in the open method. The mean access time in the open-method group was less than in the closed-method group. Other complications like visceral
injury, vascular injury, need for conversion, umbilical port site
hematoma, umbilical port site
infection, and
hernia were not observed in either group during the allocated follow-up period in the study. Conclusion: Open technique for
pneumoperitoneum is as safe and effective as the closed technique.