Advertisement

Real Benefits of the Laparoscopic Approach

  • Pietro LombariEmail author
  • Nicola Carlomagno
  • Gabriele Ricci
  • Lorenzo Asciore
  • Luca Lazzaro
  • Antonio Iannucci
Chapter
  • 1.5k Downloads

Abstract

Classical outcome measures (mortality and complications) have to be considered to compare surgical treatments. As no significant differences between laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) were found in classical outcome measures, it is justified to consider health-related quality of life (HRQoL) an important secondary outcome measure. Indeed quality of life (QoL), symptoms resolution, duration of convalescence, and patient satisfaction and well-being are at least as important as the classical outcomes from a patient’s point of view. Instruments for measuring HRQoL may be disease specific or generic. We pointed out our attention to QoL considering these main topics: effectiveness of LC, comparison to OC, comparison to small-incision laparotomic cholecystectomy (SC), and impact of iatrogenic bile duct injury (BDI). In conclusion LC is an effective operation for the treatment of biliary disease-related symptoms in patients with cholelithiasis. LC improves QoL faster than OC, while long-term results are quite similar. When comparing QoL after LC and SC, the perception of health immediately after surgery is slightly better for patients treated with laparoscopic procedure, but the gain in QoL is small and of a very limited duration.

Keywords

Laparoscopic Cholecystectomy Bile Duct Injury Open Cholecystectomy Nottingham Health Profile Karnofsky Performance Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Finan KR, Leeth RR, Whitley BM et al (2006) Improvement in gastrointestinal symptoms and quality of life after cholecystectomy. Am J Surg 192:196–202PubMedCrossRefGoogle Scholar
  2. 2.
    Lien HH, Huang CC, Wang PC et al (2010) Changes in quality-of-life following laparoscopic cholecystectomy in adult patients with cholelithiasis. J Gastrointest Surg 14:126–130PubMedCrossRefGoogle Scholar
  3. 3.
    Shi HY, Lee HH, Tsai MH et al (2011) Long-term outcomes of laparoscopic cholecystectomy: a prospective piecewise linear regression analysis. Surg Endosc 25(7):2132–2140PubMedCrossRefGoogle Scholar
  4. 4.
    Kahokehr A, Broadbent E, Wheeler BR et al (2012) The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 26(6):1730–1736PubMedCrossRefGoogle Scholar
  5. 5.
    Korolija D, Sauerland S, Wood-Dauphinée S et al (2004) Evaluation of quality of life after laparoscopic surgery. Surg Endosc 18:879–897PubMedCrossRefGoogle Scholar
  6. 6.
    Barkun JS, Barkun AN, Sampalis JS et al (1992) Randomized controlled trial of laparoscopic versus mini-cholecystectomy. The McGill Gallstone Treatment Group. Lancet 340:1116–1119PubMedCrossRefGoogle Scholar
  7. 7.
    McMahon AJ, Russell IT, Baxter JN et al (1994) Laparoscopic versus minilaparotomy cholecystectomy: a randomized clinical trial. Lancet 343:135–138PubMedCrossRefGoogle Scholar
  8. 8.
    Sanabria JR, Clavien PA, Cywes R et al (1993) Laparoscopic versus open cholecystectomy: a matched study. Can J Surg 36:330–336PubMedGoogle Scholar
  9. 9.
    Eypasch E (1993) Immediate improval in quality of life after laparoscopic cholecystectomy. Minim Invasive Ther 2:139–146CrossRefGoogle Scholar
  10. 10.
    Ludwig K, Patel K, Willhem L et al (2002) Prospektive Analyse zur Outcomebewertung nach laparoskopischer versus konventioneller Cholecystektomie. Zentralbl Chir 127:41–47PubMedCrossRefGoogle Scholar
  11. 11.
    Plaisier PW, van der Hul RL, Nijs HGT et al (1995) Quality of life and the course of biliary and gastrointestinal symptoms after laparoscopic and conventional cholecystectomy. Dig Surg 12:87–91CrossRefGoogle Scholar
  12. 12.
    Chen L, Tao SF, Xu Y et al (2005) Patients’ quality of life after laparoscopic or open cholecystectomy. J Zhejiang Univ Sci B 6(7):678–681PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Kane RL, Lurie N, Borbas C et al (1995) The outcomes of elective laparoscopic and open cholecystectomies. J Am Coll Surg 180:136–145PubMedGoogle Scholar
  14. 14.
    Topcu O (2003) Comparison of long-term quality of life after laparoscopic and open cholecystectomy. Surg Endosc 17:291–295PubMedCrossRefGoogle Scholar
  15. 15.
    Quintana JM, Cabriada J, Aróstegui I et al (2003) Quality-of-life outcomes with laparoscopic vs open cholecystectomy. Surg Endosc 17(7):1129–1134PubMedCrossRefGoogle Scholar
  16. 16.
    Velanovich V (2000) Laparoscopic vs open surgery: a preliminary comparison of quality-of-life outcomes. Surg Endosc 14(1):16–21PubMedCrossRefGoogle Scholar
  17. 17.
    Hsueh LN, Shi HY, Wang TF et al (2011) Health-related quality of life in patients undergoing cholecystectomy. Kaohsiung J Med Sci 27(7):280–288PubMedCrossRefGoogle Scholar
  18. 18.
    Matovic E, Hasukic S, Ljuca F et al (2012) Quality of Life in patients after laparoscopic and open cholecystectomy. Med Arh 66(2):97–100PubMedCrossRefGoogle Scholar
  19. 19.
    Squirrell DM, Majeed AW, Troy G et al (1998) A randomized prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 123:485–495PubMedCrossRefGoogle Scholar
  20. 20.
    Nilsson E, Ros A, Rahmqvist M et al (2004) Cholecystectomy: costs and health-related quality of life: a comparison of two techniques. Int J Qual Health Care 16(6):473–482PubMedCrossRefGoogle Scholar
  21. 21.
    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 9:147–148PubMedGoogle Scholar
  22. 22.
    Keus F, de Vries J, Gooszen HG et al (2008) Laparoscopic versus small-incision cholecystectomy: health status in a blind randomised trial. Surg Endosc 22(7):1649–1659.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Boerma D, Rauws EA, Keulemans YC et al (2001) Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis. Ann Surg 234:750–757PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Moore DE, Feurer ID, Holzman MD et al (2004) Long-term detrimental effect of bile duct injury on health-related quality of life. Arch Surg 139(5):476–481; discussion 481–482PubMedCrossRefGoogle Scholar
  25. 25.
    de Reuver PR, Sprangers MA, Rauws EA et al (2008) Impact of bile duct injury after laparoscopic cholecystectomy on quality of life: a longitudinal study after multidisciplinary treatment. Endoscopy 40(8):637–643PubMedCrossRefGoogle Scholar
  26. 26.
    Melton GB, Lillemoe KD, Cameron JL et al (2002) Major bile duct injuries associated with laparoscopic cholecystectomy: effect of surgical repair on quality of life. Ann Surg 235:888–895PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Sarmiento JM, Farnell MB, Nagorney DM et al (2004) Quality-of-life assessment of surgical reconstruction after laparoscopic cholecystectomy-induced bile duct injuries. Arch Surg 139:483–489PubMedCrossRefGoogle Scholar
  28. 28.
    Hogan AM, Hoti E, Winter DC et al (2009) Quality of life after iatrogenic bile duct injury: a case control study. Ann Surg 249(2):292–295PubMedGoogle Scholar
  29. 29.
    Landman MP, Feurer ID, Moore DE et al (2013) The long-term effect of bile duct injuries on health-related quality of life: a meta-analysis. HBP (Oxford) 15(4):252–259CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Pietro Lombari
    • 1
    Email author
  • Nicola Carlomagno
    • 2
  • Gabriele Ricci
    • 3
  • Lorenzo Asciore
    • 2
  • Luca Lazzaro
    • 4
  • Antonio Iannucci
    • 1
  1. 1.Department of General Surgery OncologyAORN Azienda Ospedaliera Sant’Anna e San SebastianoCasertaItaly
  2. 2.Department of General SurgeryAOU Federico IINaplesItaly
  3. 3.Department of General SurgeryAzienda Ospedaliera San Camillo ForlaniniRomeItaly
  4. 4.Department of General SurgeryP.O. San Tommaso dei BattutiPortogruaroItaly

Personalised recommendations