Laparoscopic Versus Open Cholecystectomy: A Prospective Matched-Cohort Study

ROBERT J. PORTE ； BAS C. DE VRIES

《HPB Surgery》 1996卷 (1996/12) Pp. 71-75

https://doi.org/10.1155/1996/32413

摘要

To compare the results of laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) for symptomatic cholelithiasis in elective surgery we performed a prospective matched-cohort study. Hundred consecutive patients who underwent LC in the period Sept. 1990-June 1992, and 100 patients who were age and sex matched and underwent an elective OC in the foregoing two years (1989-1990) were studied. The median operation time for LC (75, 40-180 min) was significantly longer than for OC (55, 20-155 min; p ＜ 0.001). Postoperative hospitalization was significantly shorter after LC (3, 1-16 days), compared with OC (7, 4-22 days; p＜0.001). Conversion of LC to OC occurred in 12 (12%) patients initially scheduled to undergo LC. Complications occurred in 5 patients (5%) after LC and in 5 patients (5%) after OC. The calculated expenses (operation and postoperative hospitalization, 3rd class) were approximately ft. 3740,- for LC (excl. investments for pieces of apparatus) and ft. 6725,- for OC. This study demonstrates that LC can be performed safely with the number of complications comparable to those for OC. Bile duct injury is a serious potential threat. The main advantages of LC are the minimal trauma, with more rapid recovery. Insurers seem to benefit from reduced postoperative disability and earlier discharge.

關鍵字

Laparoscopic cholecystectomy open cholecystectomy ； complications ； costs