Persistent symptoms after cholecystectomy are common, occurring in up
to 40 per cent of patients. Severe pain persists in 10 per cent of cas
es. A total of 450 patients were studied, 200 after open cholecystecto
my and 250 after the laparoscopic operation. Patient notes were review
ed and a postal questionnaire was circulated. Responses were obtained
from 155 patients (77.5 per cent) undergoing open cholecystectomy and
205 (82.0 per cent) having the laparoscopic operation. Mean(s.d.) foll
ow-up was 32(23) months after open cholecystectomy and 15(7) months af
ter the laparoscopic procedure. Right upper quadrant pain was more com
mon after open cholecystectomy (9.7 versus 3.4 per cent, P < 0.05). In
digestion and heartburn were equally prevalent in the two groups. Some
59.4 per cent of patients were free from symptoms after open cholecys
tectomy compared with 63.4 per cent following the laparoscopic operati
on; there was symptomatic improvement in 30.3 and 31.7 per cent respec
tively. Symptoms were the same or worse in 10.3 per cent of patients a
fter open cholecystectomy compared with 4.9 per cent after the laparos
copic operation (P < 0.05). Patients report significantly less right u
pper quadrant pain after laparoscopic than after open cholecystectomy.