Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial

SummaryAlthough laparoscopic cholecystectomy has rapidly become routine practice in the UK, there has been no rigorous comparison of it with open cholecystectomy. In our trial, 302 patients were randomised to laparoscopic or minilaparotomy cholecystectomy. Recovery after surgery was assessed by leng...

Full description

Saved in:

Bibliographic Details
Published in:	The Lancet (British edition) 1994-01, Vol.343 (8890), p.135-138
Main Authors:	McMahon, A.J., Baxter, J.N., Anderson, J.R., Ramsay, G., O'Dwyer, P.J., Russell, I.T., Ross, S., Sutherland, G., Galloway, D., Morran, C.G.
Format:	Article
Language:	eng
Subjects:	Activities of Daily Living Bile Biological and medical sciences Cholecystectomy Cholecystectomy - economics Cholecystectomy - methods Cholecystectomy, Laparoscopic - economics Complications Evidence-based medicine Gallbladder Hospital Costs Humans Laparoscopy Laparotomy Length of Stay Liver, biliary tract, pancreas, portal circulation, spleen Medical research Medical sciences Mental depression Pain Patients Postoperative Complications Randomization Scars Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Treatment Outcome United Kingdom
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	SummaryAlthough laparoscopic cholecystectomy has rapidly become routine practice in the UK, there has been no rigorous comparison of it with open cholecystectomy. In our trial, 302 patients were randomised to laparoscopic or minilaparotomy cholecystectomy. Recovery after surgery was assessed by length of hospital stay, outpatient review at 10 days and 4 weeks, and patient questionnaires 1, 4, and 12 weeks after surgery. The mean operation time was 14 min shorter for minilaparotomy, while median post-operative hospital stay was 2 days shorter after laparoscopic cholecystectomy. The hospital costs were about £400 greater for the laparoscopic procedure. Laparoscopic patients returned to work in the home sooner; at 1 week, they had better physical and social functioning, were less limited by physical problems, and had less pain and depression. At 4 weeks, only physical functioning and depression scores were better in the laparoscopic group, and by 3 months there were no differences. Laparoscopic patients were more satisfied with the appearance of their scars. The incidence of complications after both procedures was 20%. Compared to minilaparotomy cholecystectomy, laparoscopic cholecystectomy results in shorter hospital stay, less postoperative dysfunction, and quicker return to normal activities, but is more costly.
ISSN:	0140-6736 1474-547X