Abstract

Background: Gallstone disease is a prevalent gastrointestinal disorder with substantial economic and healthcare burdens globally. Symptomatic gallstone disease, in particular, necessitates effective management strategies to alleviate patient suffering and curb escalating healthcare costs. This study aimed to investigate the comparative efficacy and safety of laparoscopic cholecystectomy versus conservative management in patients with symptomatic gallstone disease, informing evidence-based treatment decisions and healthcare resource allocation

Methods: Study conducted at tertiary care hospitals of Rawalpindi, from Jan 2021 to December 2023, this retrospective cohort study included 108 patients: 54 under conservative management and 54 undergoing laparoscopic cholecystectomy. Data encompassed demographics, clinical presentation, treatments, and outcomes. Primary outcomes focused on complications, symptom resolution, and quality of life, while secondary outcomes included hospital stays, readmission rates, and healthcare costs. Statistical analysis used SPSS version 25.

Results: Laparoscopic cholecystectomy demonstrated significantly lower complication rates (9% vs. 26%, p = 0.015), higher complete symptom resolution (94% vs. 78%, p = 0.025), and superior quality of life improvements (91% vs. 70%, p = 0.006) compared to conservative management. In the laparoscopic group, hospital stays were shorter (2.1 ± 0.6 days vs. 3.8 ± 1.2 days, p < 0.001). Recurrence rates were considerably lower in the laparoscopic group at the one-year follow-up (0% vs. 18%, p < 0.001).

Conclusion: Laparoscopic cholecystectomy emerges as the preferred treatment for symptomatic gallstone disease, offering better clinical outcomes, improved quality of life, and reduced healthcare costs compared to conservative management. These findings advocate for surgical intervention in the management of symptomatic gallstone disease and call for further prospective studies to validate these results and refine treatment guidelines