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A Prospective, Randomized Study Comparing Minilaparotomy and Laparoscopic Cholecystectomy as a Day-Surgery Procedure: 5-Year Outcome

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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.

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Disclosures

Samuli Aspinen, Jukka Harju, Petri Juvonen, Kalevi Karjalainen, Hannu Kokki, Hannu Paajanen, and Matti Eskelinen have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

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

    Samuli Aspinen, Hannu Kokki, Hannu Paajanen & Matti Eskelinen

  2. Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland

    Jukka Harju

  3. Department of Surgery, Kuopio University Hospital, PL 1777, 70211, Kuopio, Finland

    Petri Juvonen, Hannu Paajanen & Matti Eskelinen

  4. Kuusankoski District Hospital, Kouvola, Finland

    Kalevi Karjalainen

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

    Hannu Kokki

Authors
  1. Samuli Aspinen
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  2. Jukka Harju
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  3. Petri Juvonen
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  4. Kalevi Karjalainen
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  5. Hannu Kokki
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  6. Hannu Paajanen
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  7. Matti Eskelinen
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Correspondence to Matti Eskelinen.

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Aspinen, S., Harju, J., Juvonen, P. et al. A Prospective, Randomized Study Comparing Minilaparotomy and Laparoscopic Cholecystectomy as a Day-Surgery Procedure: 5-Year Outcome. Surg Endosc 28, 827–832 (2014). https://doi.org/10.1007/s00464-013-3214-y

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  • DOI: https://doi.org/10.1007/s00464-013-3214-y

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