Laparoscopic versus open cholecystectomy: a prospective randomized study

A prospective randomized study of laparoscopic versus open cholecystectomy was carried out fro December 1991 to June 1992 at the Chang Gung Memorial Hospital. Laparoscopic cholecystectomy was performed in 50 cases in group A and open cholecystectomy in 51 cases in group B. All patients had a preoperative history of biliary tract disease and most had gall stones proved by sonography. There was no operative mortality in either group and the postoperative complication rates were 4.4% and 2% in group A and B respectively (p > 0.05). Prolonged operative time in group A was 85.7 +/- 25.2 min vs group B 48.0 +/- 13.9 min (p < 0.001). Postoperative bowel function recovery with toleration of a regular diet in group A was faster than group B (45.6 +/- 19.2 hrs vs 55.2 +/- 11.0 hrs, p < 0.001). The need for postoperative narcotic drugs with demerol injection was less in group A (40%) than group B (86%) (p < 0.001). The total cost for group A was NT $42139 +/- 7135 and for group B was NT $38085 +/- 7578 (p > 0.05). The interval of return to full activity for group A was shorter than group B (12.8 +/- 8.8 days vs 35.9 +/- 20.6 days respectively p < 0.001). Recurrent symptoms within the 6 to 13 month postoperative follow up period was 8% in group A and 11.7% in group B (p > 0.05). Only one patient in group B was proved to have a recurrent common bile duct stone by endoscopic retrograde cholangiography and received choledocholithotomy again.