Of concern is a significant increase in its use by patients who have inflammation in the gallbladder but no gallstones and even in those who have no symptoms. Experts report that although laparoscopy has reduced hospital stays, overall medical costs have increased because more operations are being performed. Some experts argue that open cholecystectomy may even be better than laparoscopy as initial surgery in certain situations. They argue that even as experience increases, studies are reporting a higher complication rate, particularly in injuries to the bile duct, for laparoscopy than with open cholecystectomy. The patient usually needs to stay in the hospital for five to seven days and may not return to work for a month.
Some experts believe, however, that it has a number of advantages compared to laparoscopy.
It is faster to perform, less expensive, and may have fewer complications. The riskiness of this procedure increases with other factors, such as the age of the patient or if common bile duct exploration for duct stones is necessary at the same time as the cholecystectomy. As in laparoscopic cholecystectomy, bile duct injury is a possible complication, which requires additional and difficult operations. Minilaparotomy is another variant of open cholecystectomy and uses a much smaller incision. Wider experience will be required, however, before it is known with certainty whether minilaparotomy with its greatly diminished ability to see abdominal structures is as safe as standard approaches.