PMID- 10881952
OWN - NLM
STAT- MEDLINE
DCOM- 20001201
LR  - 20220317
IS  - 1102-4151 (Print)
IS  - 1102-4151 (Linking)
VI  - 166
IP  - 5
DP  - 2000 May
TI  - Laparoscopic or open cholecystectomy: a prospective randomised trial to compare 
      postoperative pain, pulmonary function, and stress response.
PG  - 394-9
AB  - OBJECTIVE: Open cholecystectomy (OC) has been superseded by laparoscopic 
      cholecystectomy (LC) for the treatment of cholelithiasis, although this fashion 
      has not been validated by prospective studies. Our aim was to compare the two 
      techniques. DESIGN: Prospective, randomised, open study. SETTING: University 
      hospital, Finland. PATIENTS: 49 patients who required cholecystectomy for 
      cholelithiasis confirmed by ultrasound. INTERVENTIONS: 49 patients were randomly 
      allocated to LC (n = 27) or OC (n = 22): 25 and 22, respectively, eventually had 
      the operation. LC was done using a four-trocar technique, and OC through a 
      transverse right subcostal incision, as short as possible. MAIN OUTCOME MEASURES: 
      Length of hospital stay and the duration of the sick leave were the primary 
      outcome measures. Secondary outcome measures were: postoperative pain evaluated 
      by visual analogue scale (VAS) and the need for opioids; pulmonary function 
      measured by forced vital capacity (FVC), forced expiratory volume in one second 
      (FEV1), peak flow velocity (PEFV), and arterial oxygen tension (PaO2), and 
      endocrine stress measured by plasma catecholamines, cortisol and glucose 
      concentrations. RESULTS: The median (range) hospital stay was significantly 
      shorter after LC than OC, being 2.0 (1-15) compared with 4.5 (2-19) days p < 
      0.01. The duration of sick leave was also significantly shorter after LC than OC, 
      being 14 (7-17) compared with 29 (4-34), p < 0.01. Patients had significantly 
      less postoperative pain after LC than OC as reflected by the need for opioids. 
      Pulmonary function and arterial oxygen tension deteriorated significantly less 
      after LC than OC. The stress response was equal. There were three documented 
      complications, one pneumonia after LC and two wound infections after OC. 
      CONCLUSIONS: LC gives significantly better results in terms of less postoperative 
      pain, better pulmonary function, better arterial oxygenation, and shorter 
      hospital stay and duration of sick leave.
FAU - Hendolin, H I
AU  - Hendolin HI
AD  - Department of Anaesthesia, Kuopio University Hospital, Finland.
FAU - Paakonen, M E
AU  - Paakonen ME
FAU - Alhava, E M
AU  - Alhava EM
FAU - Tarvainen, R
AU  - Tarvainen R
FAU - Kemppinen, T
AU  - Kemppinen T
FAU - Lahtinen, P
AU  - Lahtinen P
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur J Surg
JT  - The European journal of surgery = Acta chirurgica
JID - 9105264
SB  - IM
MH  - Cholecystectomy/*methods
MH  - *Cholecystectomy, Laparoscopic
MH  - Cholelithiasis/*surgery
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative
MH  - Prospective Studies
MH  - Pulmonary Ventilation
MH  - Stress, Physiological/physiopathology
EDAT- 2000/07/06 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/07/06 11:00
PHST- 2000/07/06 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/07/06 11:00 [entrez]
AID - 10.1080/110241500750008961 [doi]
PST - ppublish
SO  - Eur J Surg. 2000 May;166(5):394-9. doi: 10.1080/110241500750008961.