The introduction of laparoscopic cholecystectomy--audit of transition period with late follow-up.
The operative treatment of 356 consecutive patients with gallstone related disease who presented in the thirty months following the introduction of laparoscopic cholecystectomy was reviewed. A standard questionnaire, with emphasis on total hospital stay (including convalescence), late postoperative morbidity and time to return to work/full activity was sent to all patients. Two hundred and ninety-eight patients responded (83%). The median duration of follow-up was 19 months, (range 6-36 months). Patients who underwent laparoscopic cholecystectomy spent significantly less time in hospital post-operatively (median 3 days, interquartile range 2-4) than either those who required conversion to open cholecystectomy (median 7.5 days, interquartile range 5.5-10) or those who had planned open cholecystectomy (median 9.5 days, interquartile range 5-13), (p < 0.001, Kruskal-Wallis). Planned gall bladder extraction through the umbilical port site was associated with a significantly higher probability of wound infection compared with extraction through the epigastric port site (chi 2 = 4.977, P < 0.05). The median time to return to work/full activity was significantly shorter after laparoscopic cholecystectomy (median 21 days, interquartile range 14-42), than after open cholecystectomy (median 42 days, interquartile range 21-60) or following conversion to open cholecystectomy (median 56 days, interquartile range 35-60). We conclude that laparoscopic cholecystectomy requires a significantly shorter hospitalisation than open cholecystectomy and facilitates early return to work/full activity.
Kent
P
P
Department of Surgery, Mater Misericordiae Hospital, Dublin.
Bannon
C A
CA
Beausang
O
O
O'Connell
P R
PR
Corrigan
T P
TP
Gorey
T F
TF
D002763:Cholecystectomy / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000534:rehabilitation / Q000706:statistics & numerical data*; D002769:Cholelithiasis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D007902:Length of Stay / Q000706:statistics & numerical data*; D008485:Medical Audit; D011183:Postoperative Complications / Q000209:etiology* / Q000534:rehabilitation; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data