Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: a prospective randomised trial.
BACKGROUND
Laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) are the two most commonly performed mini-invasive surgical techniques for the treatment of symptomatic gallstone disease, but the long-term outcome after these two procedures has not been compared in prospective clinical trials. We therefore investigated the outcome after LC and MC in 127 patients operated at Kuopio University Hospital.


METHODS
Initially 157 patients with uncomplicated symptomatic gallstones were randomised to MC (n = 85) or LC (n = 72) over a 5-year period (1998-2004), and 127 of them (81 %), 69/85 with MC and 58/72 with LC, were reached for a follow-up interview 10.5 (7.3-13.6) years after the surgery.


RESULTS
Baseline and surgical parameters were similar in the two groups; 3/69 MCs and 2/58 LCs were converted to open laparotomy. The prevalence of chronic post-surgical pain 10 years after procedure was similar in the two groups: 5/69 (7 %) in the MC group and 1/58 (2 %) in the LC group (p = 0.14). Residual abdominal symptoms were common, but less frequent in the MC group (14/69; 20 %) than in the LC group (21/58 patients; 36 %) (p = 0.039). In the MC group 63/69 (91 %) and 57/58 (98 %) in the LC group (p = 0.059) were satisfied with the cosmetic outcome.


CONCLUSIONS
Our results suggest a relatively similar long-term outcome after MC and LC.
Department of Surgery, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland. jukka.harju@fimnet.fi
Jukka
J
Harju
Samuli
S
Aspinen
Petri
P
Juvonen
Hannu
H
Kokki
Matti
M
Eskelinen
D000293:Adolescent; D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011446:Prospective Studies; D055815:Young Adult