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Laparoscopic and open cholecystectomy. A prospective, randomized study
E Trondsen1, O Reiertsen, O K Andersen
1Surgical Department, Central Hospital of Akershus, Nordbyhagen, Norway.
Insights
Laparoscopic cholecystectomy is faster and leads to shorter hospital stays and recovery times compared to open surgery. This study found significant benefits favoring the laparoscopic approach for gallbladder removal.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Cholecystectomy is a common surgical procedure for gallbladder removal.
- Traditional open cholecystectomy involves a larger incision and longer recovery.
- Laparoscopic cholecystectomy offers a minimally invasive alternative.
Purpose of the Study:
- To compare the outcomes of laparoscopic cholecystectomy versus open cholecystectomy.
- To evaluate differences in operative time, hospital stay, pain, complications, and recovery.
- To determine the preferred surgical method for elective cholecystectomy.
Main Methods:
- A prospective randomized controlled trial was conducted.
- 70 patients undergoing elective cholecystectomy were randomly assigned to either open or laparoscopic groups (35 each).
- Outcomes measured included operative duration, hospital stay, postoperative pain, complications, convalescence, and sick leave.
Main Results:
- Laparoscopic cholecystectomy had a longer operative time (100 vs. 50 minutes, p < 0.01).
- Patients undergoing laparoscopic surgery experienced significantly shorter hospital stays (2 vs. 4 days, p < 0.01), less pain, and reduced sick leave (11 vs. 34 days, p < 0.01).
- Convalescence was also significantly shorter for the laparoscopic group (8 vs. 49 days, p < 0.01), with similar complication rates between groups.
Conclusions:
- Laparoscopic cholecystectomy demonstrates significant advantages over open surgery regarding recovery and hospital stay.
- The study adopted laparoscopic cholecystectomy as the standard procedure.
- Further improvements in laparoscopic techniques and patient information are suggested to enhance outcomes.
Objective:
To compare laparoscopic with open cholecystectomy.
Design:
Prospective random control trial.
Setting:
Central Hospital of Akershus, Nordbyhagen, Norway.
Subjects:
74 consecutive patients due to undergo elective cholecystecomy between October 1990 and June 1991.
Interventions:
Two patients were excluded from randomisation, and two were withdrawn after randomisation. The remaining 70 were randomly allocated to open or laparoscopic cholecystectomy (n = 35 in each group).
Main Outcome Measures:
Duration of operation and postoperative stay in hospital, amount of postoperative pain, incidence of complications, and duration of convalescence and sick leave.
Results:
Laparoscopic cholecystectomy took twice as long as open (median [range] 100 [52-180] minutes compared with 50 [15-115], p < 0.01), but patients stayed in hospital half the time (2 [1-9] days compared with 4 [2-22], p < 0.01); required less opiate analgesia (4 [0-20] doses compared with 6 [0-13], p = 0.02; took less sick leave (11 [4-267] days (n = 18) compared with 34 [20-48] (n = 22), p < 0.01); and spent less time in convalescence (8 [3-40] days (n = 17) compared with 49 [10-247] (n = 12), p < 0.01). There were six complications in the laparoscopy group and seven in the open cholecystectomy group.
Conclusion:
Because of the significant differences between laparoscopic and open cholecystectomy we have now adopted the laparoscopic method as our standard, but we think that we can improve our results further by refining our operative techniques and giving our patients more information.