LAPAROSCOPIC VERSUS OPEN CHOLECYSTECTOMY - HOSPITALIZATION, SICK LEAVE, ANALGESIA AND TRAUMA RESPONSES

Laparoscopic cholecystectomy has rapidly become established as the tre atment of choice for cholecystolithiasis. There is very little evidenc e, however, to support the claimed benefit to patients. In the present study 30 consecutive patients below the age of 65 years without acute cholecystitis and with no signs of common bile duct stones were rando mized to laparoscopic or conventional open cholecystectomy. Median (in terquartile range) intravenous consumption of pethidine with a patient -controlled injection device between 13 and 24 h after surgery was 125 (62-175) mg in patients who underwent the laparoscopic procedure and 200 (150-250) mg in those who had open operation. Urinary adrenaline a nd cortisol levels as well as those of plasma glucose, C-reactive prot ein and interleukin 6 were increased after surgery in both groups of p atients, but without any significant difference between them. The mean (s.d.) duration of postoperative hospital stay (2.8(0.8) versus 1.8(0. 6) days) and sick leave (24.0(4.4) versus 11.7(4.1) days) was signific antly longer with open than laparoscopic cholecystectomy. The findings demonstrate obvious advantages of laparoscopic surgery as regards pos toperative pain and convalescence, although factors reflecting the mag nitude of trauma did not differ.