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Published in: Surgical Endoscopy 7/2013

01-07-2013

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

Authors: Jukka Harju, Samuli Aspinen, Petri Juvonen, Hannu Kokki, Matti Eskelinen

Published in: Surgical Endoscopy | Issue 7/2013

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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.
Literature
1.
go back to reference Mühe E (1986) Die erste cholecystektomie durch das laparoskop. Langenbecks Arch Surg 369: 804 (abstract, German) Mühe E (1986) Die erste cholecystektomie durch das laparoskop. Langenbecks Arch Surg 369: 804 (abstract, German)
2.
3.
go back to reference 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 220:617–625PubMedCrossRef 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 220:617–625PubMedCrossRef
4.
go back to reference 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 389:172–177PubMedCrossRef 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 389:172–177PubMedCrossRef
5.
go back to reference 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 20:583–586PubMedCrossRef 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 20:583–586PubMedCrossRef
6.
go back to reference 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 16:321–324CrossRef 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 16:321–324CrossRef
7.
go back to reference 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 21:1294–1300PubMedCrossRef 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 21:1294–1300PubMedCrossRef
8.
go back to reference Keus F, de Vries J, Gooszen HG, van Laarhoven CJ (2008) Laparoscopic versus small-incision cholecystectomy: health status in blind randomised trial. Surg Endosc 22:1649–1659PubMedCrossRef Keus F, de Vries J, Gooszen HG, van Laarhoven CJ (2008) Laparoscopic versus small-incision cholecystectomy: health status in blind randomised trial. Surg Endosc 22:1649–1659PubMedCrossRef
9.
go back to reference 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 340:1116–1119PubMedCrossRef 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 340:1116–1119PubMedCrossRef
10.
go back to reference McMahon AJ, Russell IT, Baxter JN, Ross S, Anderson JR, Morran CG et al (1994) Laparoscopic versus minilaparotomy cholecystectomy: a randomized trial. Lancet 343:135–138PubMedCrossRef McMahon AJ, Russell IT, Baxter JN, Ross S, Anderson JR, Morran CG et al (1994) Laparoscopic versus minilaparotomy cholecystectomy: a randomized trial. Lancet 343:135–138PubMedCrossRef
11.
go back to reference 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 123:485–495PubMedCrossRef 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 123:485–495PubMedCrossRef
12.
go back to reference 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 39:773–777PubMedCrossRef 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 39:773–777PubMedCrossRef
13.
go back to reference 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 82:1378–1382PubMedCrossRef 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 82:1378–1382PubMedCrossRef
14.
go back to reference 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 9:147–148PubMed 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 9:147–148PubMed
15.
go back to reference 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 18:879–897PubMedCrossRef 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 18:879–897PubMedCrossRef
16.
go back to reference 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 80:25–32PubMed 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 80:25–32PubMed
Metadata
Title
Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: a prospective randomised trial
Authors
Jukka Harju
Samuli Aspinen
Petri Juvonen
Hannu Kokki
Matti Eskelinen
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2770-x

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