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Less pain after transvaginal cholecystectomy: single-center pooled analysis

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Abstract

Background

We previously reported outcome after transvaginal cholecystectomy (TVC) from two cohort studies and a randomized controlled trial. We now present a pooled analysis of postoperative pain scores.

Design

Single-center data of postoperative pain after TVC from a level II hospital between October 2007 and June 2012.

Methods

Female patients, above 18 years with symptomatic cholecystolithiasis, received either TVC or conventional laparoscopic cholecystectomy (CLC). Follow up 4 days. The primary outcome of the study was pain after surgery. Pain was measured via a visual rating scale. Descriptive statistics include age, body mass index (BMI), ASA grade, surgical times, number of trocars, complications and hospital stay as well as pain medication. Pain data were assessed against histologic findings.

Results

The combined register included 316 patients. Of these, 7 patients were excluded from analysis due to conversion to open surgery, complications and denial of follow-up. There were 141 patients in the TVC and 168 in the CLC group. There was no difference in age, ASA grade, surgical times, complications or hospital stay. BMI was significantly different with an average BMI of 27.1 in the TVC and 28.7 in the CLC group (p = 0.027). The numbers of trocars were significantly different as expected. There was no difference in postoperative pain medication. Pain scores were significantly different on day two to four. Multivariate testing revealed no dependence between postoperative pain and histologic findings.

Conclusion

On smaller patient numbers, we were previously unable to demonstrate a consistently, significant difference for postoperative pain in our cohort and randomized studies. The pooled analysis suggests that there is an advantage with less postoperative pain after transvaginal compared to standard laparoscopic cholecystectomy.

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Authors and Affiliations

  1. Department of General Surgery, Oberhavel Hospitals Gransee, Meseberger Weg 12-13, 16775, Gransee, Brandenburg, Germany

    Dietmar H. Borchert

  2. Department of General and Visceral Surgery, Affiliated Teaching Hospital to the Charité, Sana Hospitals Berlin-Brandenburg, Sana Hospital Lichtenberg, Fanningerstraße 32, 10365, Berlin, Germany

    Matthias Federlein & Oskar Rückbeil

  3. Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Campus Homburg, Homburg, Germany

    Jakob Schöpe

Authors
  1. Dietmar H. Borchert
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  2. Matthias Federlein
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  3. Oskar Rückbeil
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  4. Jakob Schöpe
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Corresponding author

Correspondence to Dietmar H. Borchert.

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Disclosures

Drs. Dietmar H. Borchert, Matthias Federlein, Oskar Rückbeil, and Jakob Schöpe have no conflicts of interest or financial ties to disclose.

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Borchert, D.H., Federlein, M., Rückbeil, O. et al. Less pain after transvaginal cholecystectomy: single-center pooled analysis. Surg Endosc 31, 2573–2576 (2017). https://doi.org/10.1007/s00464-016-5263-5

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  • DOI: https://doi.org/10.1007/s00464-016-5263-5

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