Skip to main content

Advertisement

SpringerLink
Log in

Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: a prospective randomised trial

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

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.

Patients and 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.

Conclusion

Our results suggest a relatively similar long-term outcome after MC and LC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Mühe E (1986) Die erste cholecystektomie durch das laparoskop. Langenbecks Arch Surg 369: 804 (abstract, German)

  2. Bittner R (2004) The standard of laparoscopic cholecystectomy. Langenbecks Arch Surg 389:157–163

    Article  PubMed  CAS  Google Scholar 

  3. Tyagi NS, Meredith MC, Lumb JC, Cacdac RG, Vanterpool CC, Rayls KR, Zerega WD, Silbergleit A (1994) A new minimal invasive technique for cholecystectomy: subxiphoid “minimal stress triangle” microceliotomy. Ann Surg 220:617–625

    Article  PubMed  CAS  Google Scholar 

  4. Syrakos T, Antonitsis P, Zacharakis E, Takis A, Manousari A, Bakogiannis K, Efthimiopoulos G, Achoulias I, Trikoupi A, Kiskinis D (2004) Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbecks Arch Surg 389:172–177

    Article  PubMed  Google Scholar 

  5. Harju J, Juvonen P, Eskelinen M, Miettinen P, Pääkkönen M (2006) Minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: a randomized study with special reference to obesity. Surg Endosc 20:583–586

    Article  PubMed  CAS  Google Scholar 

  6. Vagenas K, Spyrakopoulos P, Karanikolas M, Sakelaropoulos G, Maroulis I, Karavias D (2006) Mini-laparotomy cholecystectomy versus laparoscopic cholecystectomy: which way to go? Surg Lap Endosc Percutaneous Tech 16:321–324

    Article  Google Scholar 

  7. Purkayastha S, Tilney HS, Georgiou P, Athanasiou T, Tekkis PP, Darzi AW (2007) Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials. Surg Endosc 21:1294–1300

    Article  PubMed  Google Scholar 

  8. Keus F, de Vries J, Gooszen HG, van Laarhoven CJ (2008) Laparoscopic versus small-incision cholecystectomy: health status in blind randomised trial. Surg Endosc 22:1649–1659

    Article  PubMed  Google Scholar 

  9. Barkun JS, Barkun AN, Sampalis JS, Fried G, Taylor B, Wexler MJ, Goresky CA, Meakins JL (1992) Randomised controlled trial of laparoscopic versus mini cholecystectomyThe McGill Gallstone. Treatment Group. Lancet 340:1116–1119

    Article  PubMed  CAS  Google Scholar 

  10. McMahon AJ, Russell IT, Baxter JN, Ross S, Anderson JR, Morran CG et al (1994) Laparoscopic versus minilaparotomy cholecystectomy: a randomized trial. Lancet 343:135–138

    Article  PubMed  CAS  Google Scholar 

  11. Squirrell DM, Majeed AW, Troy G, Peacock JE, Nicholl JP, Johnson AG (1998) A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 123:485–495

    Article  PubMed  CAS  Google Scholar 

  12. Ros A, Nilsson E (2004) Abdominal pain and overall and cosmetic satisfaction one year after cholecystectomy: outcome of a randomized trial comparing laparoscopic and minilaparotomy cholecystectomy. Scand J Gastroenterol 39:773–777

    Article  PubMed  CAS  Google Scholar 

  13. McMahon AJ, Ross S, Baxter JN, Russell IT, Anderson JR, Morran CG, Sunderland GT, Galloway DJ, O’Dwyer PJ (1995) Symptomatic outcome 1 year after laparoscopic and minilaparotomy cholecystectomy: a randomized trial. Br J Surg 82:1378–1382

    Article  PubMed  CAS  Google Scholar 

  14. Harju J, Pääkkönen M, Eskelinen M (2007) Comparison of the quality of life after minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: a prospective randomized study. Isr Med Assoc J 9:147–148

    PubMed  Google Scholar 

  15. Korolija D, Sauerland S, Wood-Dauphinée S, Abbou CC, Eypasch E, Cabarello MG, Lumsden MA, Millat B, Monson JR, Nilsson G, Pointner R, Schwenk W, Shamiyeh A, Szold A, Targarona E, Ure B, Neugebauer E (2004) European Association for Endoscopic Surgery, evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 18:879–897

    Article  PubMed  CAS  Google Scholar 

  16. Gui GP, Cheruvu CV, West N, Sivaniah K, Fiennes AG (1998) Is cholecystectomy effective treatment for symptomatic gallstones? Clinical outcome after long-term follow-up. Ann R Coll Surg Engl 80:25–32

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland

    Jukka Harju

  2. School of Medicine, University of Eastern Finland, Kuopio, Finland

    Samuli Aspinen & Hannu Kokki

  3. Department of Surgery, Kuopio University Hospital, Kuopio, Finland

    Petri Juvonen & Matti Eskelinen

  4. Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland

    Hannu Kokki

Authors
  1. Jukka Harju
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samuli Aspinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Petri Juvonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hannu Kokki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matti Eskelinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jukka Harju.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harju, J., Aspinen, S., Juvonen, P. et al. Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: a prospective randomised trial. Surg Endosc 27, 2512–2516 (2013). https://doi.org/10.1007/s00464-012-2770-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-012-2770-x

Keywords

Search

Navigation