A prospective, randomized study comparing minilaparotomy and laparoscopic cholecystectomy as a day-surgery procedure: 5-year outcome

Surg Endosc. 2014 Mar;28(3):827-32. doi: 10.1007/s00464-013-3214-y. Epub 2013 Oct 3.

Abstract

Background: The long-term outcome between laparoscopic cholecystectomy (LC) and minilaparotomy (MC) has not been compared in randomised trials as day-surgery procedures. We therefore investigated the outcome after day-case LC and MC in 48 patients.

Methods: Initially 60 patients with noncomplicated symptomatic gallstone disease were randomly allocated to a day-case MC (n = 29) or LC (n = 31) over a period of 2 years (2006-2008), and 48 of them (80 %) were reached for a follow-up interview 5.8 (4.8-6.9) years after the surgery.

Results: Baseline parameters were similar in the two groups: 1 of 21 MCs and 2 of 27 LCs were converted to open laparotomy. The prevalence of chronic postsurgical pain (CPSP) 5 years after the procedure was quite similar in the two groups: 3 of 21 (14 %) in the MC group and 1 of 27 (4 %; p = 0.2). Residual abdominal symptoms were common, but the proportion was similar in both groups (43 % in MC and 30 % in LC group, p = 0.26). In the MC group 100 % and in the LC group 89 % (18/21) were satisfied with the cosmetic outcome (p = 0.11). Quality of life (QoL) improved for 16 of 21 (76 %) in the MC group and 26 of 27 (96 %) in the LC group (p = 0.38), and patients in both groups were satisfied with the operation overall.

Conclusions: Day-case MC and LC patients have a quite similar long-term outcome with no significant difference regarding residual abdominal symptoms, cosmetic satisfaction, QoL, or CPSP.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Surgical Procedures / methods*
  • Cholecystectomy, Laparoscopic / methods*
  • Cholelithiasis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparotomy / methods*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prospective Studies
  • Quality of Life
  • Time Factors
  • Treatment Outcome
  • Young Adult