COMPLICATIONS IN LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY - A PROSPECTIVE COMPARATIVE TRIAL

Laparoscopic cholecystectomy (n = 250) was compared with the open proc edure (n = 250) in a prospective comparative study focusing on complic ations. Severity grade was classified according to the Toronto system. The frequency of severity grade 1 complications was equal after open and laparoscopic cholecystectomy (5.6%), but major complications (grad e 2 and higher) were significantly more frequent in the open group (10 .4 versus 3.6%). The only postoperative death occurred after open chol ecystectomy. The conventional advantages of laparoscopic cholecystecto my were also verified: The need for postoperative analgesics was signi ficantly reduced from 7 (range, 4-16) standard opiate doses in the ope n group to 3 (range, 0-7) in the laparoscopic group, Hospital stay was reduced from 6 (range, 4-31) days after open surgery to 2 (range, 1-7 ) days after laparoscopic surgery and sick leave from 28 (range, 18-48 ) to 10 (range, 2-21) days, respectively. The overall complication rat e was significantly higher in the open group (16 versus 9%, p < 0.01). In our hands, laparoscopic cholecystectomy carries a lower risk of se rious complications than the open procedure.