Expertise-based randomized clinical trial of laparoscopic versus small-incision open cholecystectomy (Br J Surg 2013; 100: 886-894)

摘要

Sir Rosenmiiller and colleagues' expertise-based trial of laparoscopic cholecystec-tomy (LC) versus small-incision open cholecystectomy (SIOC) showed no significant differences between these two groups in conversion rate, pain, complications, hospital stay and readmission. However, operating time was significantly shorter for SIOC, whereas short-term quality of life was superior for LC. The comparability and acceptability of SIOC relative to LC is particularly important for surgeons in the developing world where limitations of operating time, hospitalization, equipment maintenance, surgical training, small numbers and cost are major determinants of treatment choice. Of 27 public hospitals in the Caribbean, only eight have adequate equipment and staff to do LC.