Cholecystitis Clinical Trial
Official title:
An Expertise-based Randomized Controlled Trial Comparing Minilaparotomy Cholecystectomy and Laparoscopic Cholecystectomy
The trial compares minilaparotomy (small-incision) cholecystectomy with (key-hole) laparoscopic cholecystectomy by randomly allocating patients with gallbladder disease to two groups of surgeons, each group being trained for one of the two methods.
Small-incision open cholecystectomy (minilaparotomy) for gallbladder disease has been proven
superior to conventional open cholecystectomy. However, it was rapidly overshadowed by
laparoscopic cholecystectomy when the latter method was introduced. Today, some 25% of all
gallbladder surgery is done with the conventional open cholecystectomy, often on elderly and
frail patients. Previous trials comparing minilaparotomy and laparoscopic cholecystectomy
have been hampered by surgeons´ different expertise with the two methods. These studies
indicate that operation time is shorter and that health care cost is lower for
minilaparotomy compared to laparoscopic cholecystectomy, but hard data are scarce. The
objective of the present trial is to randomize eligible patients to two groups of surgeons,
well trained in either minilaparotomy cholecystectomy or laparoscopic cholecystectomy.
Surgeons in the minilaparotomy group will consider extension of the incision when necessary,
and surgeons in the laparoscopic group will aim for laparoscopic cholecystectomy with
conversion to open cholecystectomy if this is indicated. The design of the study allows wide
inclusion criteria for participants, a cost-utility approach in the analysis, and a high
external validity of the conclusions reached.
Comparison: Minilaparotomy cholecystectomy compared to laparoscopic cholecystectomy for
gallbladder disease.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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