[Prospective study on patients outcome following laparoscopic vs. open cholecystectomy].
OBJECTIVE
Differences in outcome between patients undergoing laparoscopic (LC) vs. open cholecystectomy (OC) should be examined under objective and subjective aspects.


METHODS
We prospectively evaluated the postoperative course of 135 patients who underwent LC or OC in 1999. In the first step we examined the recover period with the help of the modified McPeek-Index. In the second phase during a 35 postoperative days-spanned analysis all patients noted there physical, emotional and social well-being in a circulating standard questionnaire, based on the modified Gastrointestinal Quality Life Index (GIQLI).


RESULTS
Responses were obtained from 103 patients (76.3 %) undergoing 29 OC and 74 LC. 21.4 % of the patients aged 70 and older or had perioperative risks > II in ASA-Classification (LC 19.8 vs. OC 30.1 %). The (objective) McPeek-Outcome was similar in both groups, with no statistical advantage for LC (best score: 69 % LC vs. 62 % OC). The subjective assessment of the patients showed that patients having LC felt fully fit 10.2 days earlier than patients after OC (23.9 vs. 34.1 days). Patients in the LC-group returned to work after an average of 24.7 days, compared with 42.2 days following OC. The main finding of the postal questionnaire was a significantly earlier recruitment in physical, emotional and social status following LC in the group of aged > 70 and > ASA II-Score-patients, in contrast to control-OC-group.


CONCLUSIONS
The study suggests an additional advantage in surgical outcome after LC, in comparison to OC. The laparoscopic approach is the preferable procedure to treat especially older and comorbide patients, when local or anesthesiological contraindications are absent.
Ludwig
K
K
Chirurgische Klinik, Klinikum Südstadt Rostock.
Pätel
Katrin
K
Wilhelm
L
L
Bernhardt
J
J
D000368:Aged; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017562:Postcholecystectomy Syndrome / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome