[Elective cholecystectomy by celioscopy versus subcostal approach cholecystectomy. Comparative study of postoperative pain and discomfort]. / Cholécystectomie élective par coelioscopie versus abord sous-costal. Etude comparative de la douleur et du confort post-opératoire.

ABSTRACT

The aim of this prospective study was to evaluate postoperative pain and discomfort in 70 patients undergoing cholecystectomy. The choice of surgical approach was left to the surgeon. Accordingly, these patients were then divided in two groups laparoscopic cholecystectomy (group I; n = 37); classic cholecystectomy (subcostal incision) (group II; n = 33). There was no significant difference between these groups concerning weight/height ratio, size and number of stones. Patients in group II were older (55 +/- 16 years) than those in group I (46 +/- 11 years) (P < 0.01). The mean duration of surgery was shorter in group II (96 +/- 31 min) than in group I (119 +/- 49 min) (P < 0.01). Postoperative discomfort was evaluated by (group I versus group II respectively) a) the mean length of hospital stay after surgery (3.7 +/- 1.5 versus 6.7 +/- 1.1 days, P < 0.02); b) the mean delay to return of intestinal motility (1.5 +/- 0.6 versus 2.0 +/- 0.6 days, P < 0.001); c) the mean perfusion time (1.4 +/- 0.6 versus 2.6 +/- 0.8 days, P < 0.001); d) intensity of postoperative pain which was evaluated daily. There was no significant difference between these two groups concerning the use of analgesics; however, a statistically significant difference was found in the visual and verbal scales, starting on the second postoperative day and in autonomy as early as the first postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)