A Prospective, Randomized Study Comparing Minilaparotomy and Laparoscopic Cholecystectomy as a Day-Surgery Procedure: 5-Year Outcome

作者：Aspinen Samuli; Harju Jukka; Juvonen Petri; Karjalainen Kalevi; Kokki Hannu; Paajanen Hannu; Eskelinen Matti^*

来源：Surgical Endoscopy and Other Interventional Techniques, 2014, 28(3): 827-832.

DOI：10.1007/s00464-013-3214-y

• Cholecystectomy
• Day surgery
• Laparoscopy
• Minilaparotomy
• Randomised controlled trial
• Treatment outcome

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.
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.
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.
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.

• 出版日期2014-3