Surgical Endoscopy

, Volume 14, Issue 4, pp 340–344

Pain after microlaparoscopic cholecystectomy

A randomized double-blind controlled study

Authors

  • T.  Bisgaard
    • Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark
  • B.  Klarskov
    • Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark
  • R.  Trap
    • Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark
  • H.  Kehlet
    • Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark
  • J.  Rosenberg
    • Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, DK-2650, Hvidovre, Denmark
Article

DOI: 10.1007/s004640020014

Cite this article as:
Bisgaard, T., Klarskov, B., Trap, R. et al. Surg Endosc (2000) 14: 340. doi:10.1007/s004640020014

Abstract

Background: Laparoscopic cholecystectomy (LC) is traditionally performed with two 10-mm and two 5-mm trocars. The effect of smaller port incisions on pain has not been established in controlled studies.

Methods: In a double-blind controlled study, patients were randomized to LC or cholecystectomy with three 2-mm trocars and one 10-mm trocar (micro-LC). All patients received a multimodal analgesic regimen, including incisional local anesthetics at the beginning of surgery, NSAID, and paracetamol. Pain was registered preoperatively, for the first 3 h postoperatively, and daily for the 1st week.

Results: The study was discontinued after inclusion of 26 patients because five of the 13 patients (38%) randomized to micro-LC were converted to LC. In the remaining 21 patients, overall pain and incisional pain intensity during the first 3 h postoperatively increased in the LC group (n= 13) compared with preoperative pain levels (p < 0.01), whereas pain did not increase in the micro-LC group (n= 8).

Conclusions: Micro-LC in combination with a prophylactic multimodal analgesic regimen reduced postoperative pain for the first 3 h postoperatively. However, the micro-LC led to an unacceptable rate of conversion to LC (38%). The micro-LC instruments therefore need further technical development before this surgical technique can be used on a routine basis for laparoscopic cholecystectomy.

Key words: Gallbladder — Microlaparoscopic cholecystectomy — Pain — Randomized controlled trial

Copyright information

© Springer-Verlag New York Inc. 2000