Long-term pain: less common after laparoscopic than open cholecystectomy

Area of Science:

• Gastroenterology and Surgery

Background:

• Persistent symptoms post-cholecystectomy affect up to 40% of patients.
• Severe pain occurs in 10% of cases, impacting quality of life.

Purpose of the Study:

• To compare the incidence of persistent symptoms after open versus laparoscopic cholecystectomy.
• To evaluate patient-reported outcomes and pain levels following both surgical approaches.

Main Methods:

• A study involving 450 patients (200 open, 250 laparoscopic cholecystectomy).
• Review of patient records and a postal questionnaire for data collection.
• Follow-up periods averaged 32 months (open) and 15 months (laparoscopic).

Main Results:

• Right upper quadrant pain was significantly more frequent after open cholecystectomy (9.7% vs 3.4%).
• Overall symptom-free rates were similar (59.4% open, 63.4% laparoscopic), with comparable improvement rates.
• Worse or same symptoms occurred in 10.3% after open vs 4.9% after laparoscopic surgery.

Conclusions:

• Laparoscopic cholecystectomy is associated with significantly less right upper quadrant pain compared to open cholecystectomy.
• While overall symptom rates are similar, the laparoscopic approach may offer better outcomes regarding specific pain locations.