title: A prospective, randomized study comparing minilaparotomy and laparoscopic cholecystectomy as a day-surgery procedure: 5-year outcome.
abstract: BACKGROUND
  The long-term outcome between laparoscopic cholecystectomy (LC) and minilaparotomy (MC) has not been compared in randomised trials as day-surgery procedures. We therefore investigated the outcome after day-case LC and MC in 48 patients.
  
  
  METHODS
  Initially 60 patients with noncomplicated symptomatic gallstone disease were randomly allocated to a day-case MC (n = 29) or LC (n = 31) over a period of 2 years (2006-2008), and 48 of them (80 %) were reached for a follow-up interview 5.8 (4.8-6.9) years after the surgery.
  
  
  RESULTS
  Baseline parameters were similar in the two groups: 1 of 21 MCs and 2 of 27 LCs were converted to open laparotomy. The prevalence of chronic postsurgical pain (CPSP) 5 years after the procedure was quite similar in the two groups: 3 of 21 (14 %) in the MC group and 1 of 27 (4 %; p = 0.2). Residual abdominal symptoms were common, but the proportion was similar in both groups (43 % in MC and 30 % in LC group, p = 0.26). In the MC group 100 % and in the LC group 89 % (18/21) were satisfied with the cosmetic outcome (p = 0.11). Quality of life (QoL) improved for 16 of 21 (76 %) in the MC group and 26 of 27 (96 %) in the LC group (p = 0.38), and patients in both groups were satisfied with the operation overall.
  
  
  CONCLUSIONS
  Day-case MC and LC patients have a quite similar long-term outcome with no significant difference regarding residual abdominal symptoms, cosmetic satisfaction, QoL, or CPSP.
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Samuli
authors.initials: S
authors.lastname: Aspinen
authors.forename: Jukka
authors.initials: J
authors.lastname: Harju
authors.forename: Petri
authors.initials: P
authors.lastname: Juvonen
authors.forename: Kalevi
authors.initials: K
authors.lastname: Karjalainen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kokki
authors.forename: Hannu
authors.initials: H
authors.lastname: Paajanen
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult