Abdominal pain and patient overall and cosmetic satisfaction one year after cholecystectomy: outcome of a randomized trial comparing laparoscopic and minilaparotomy cholecystectomy.
BACKGROUND
Previous studies with long-term follow-up after cholecystectomy have shown that residual abdominal symptoms are common. Laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) can both give a smoother, early postoperative course than conventional open cholecystectomy (OC). The present study concerns abdominal pain and patient overall and cosmetic satisfaction one year after LC and MC.


METHODS
In a prospective, single-blind study, 724 patients were randomly allocated to LC or MC. Patients completed questionnaires including items concerning abdominal pain before and one year after surgery and overall and cosmetic satisfaction one year after surgery.


RESULTS
There was no difference in reduction of abdominal pain between LC and MC patients. For four different aspects of abdominal pain, 31%, 24%, 30% and 16% of patients operated with LC reported residual abdominal pain one year after surgery. The corresponding figures for MC were 28%, 20%, 27% and 18% (P values 0.55, 0.32, 0.55 and 0.63, respectively). According to questionnaire answers, there was no significant difference in the cosmetic result and overall patient satisfaction between LC and MC patients.


CONCLUSIONS
There are no differences between laparoscopic and minilaparotomy cholecystectomy in long-term outcome regarding abdominal pain and patient overall and cosmetic satisfaction. A large proportion of patients have abdominal pain one year after cholecystectomy. Future studies should include preoperative assessment and indications for cholecystectomy.
Ros
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Dept. of Surgery, Ryhov County Hospital, Jönköping, Sweden. axel.ros@lj.se
Nilsson
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D015746:Abdominal Pain / Q000209:etiology*; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D002921:Cicatrix / Q000209:etiology; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016037:Single-Blind Method