Open Access Highly Accessed Open Badges Research article

Open cholecystectomy for all patients in the era of laparoscopic surgery – a prospective cohort study

Jonas Leo, Goran Filipovic, Julia Krementsova, Rickard Norblad, Mattias Söderholm and Erik Nilsson*

BMC Surgery 2006, 6:5  doi:10.1186/1471-2482-6-5

PubMed Commons is an experimental system of commenting on PubMed abstracts, introduced in October 2013. Comments are displayed on the abstract page, but during the initial closed pilot, only registered users can read or post comments. Any researcher who is listed as an author of an article indexed by PubMed is entitled to participate in the pilot. If you would like to participate and need an invitation, please email, giving the PubMed ID of an article on which you are an author. For more information, see the PubMed Commons FAQ.

Length of stay comparison.

Erik Nilsson   (2009-03-06 21:01)  Instituion of surgery and perioperative sciences, Umeå university, Sweden email

In our study, hospital stay for all patients (3.1 days) was compared with hospital stay for all patients who had cholecystectomy in Sweden 2002 (4.4 days). However, in a subsequent study we found that after exclusion of patients with malignant or benign intra-abdominal or kidney tumor with a procedure code for tumor resection, the mean in-hospital stay for patients who had cholecystectomy in Sweden 2002-03 was 4.1 days[1]. After adjustment for 12% ambulatory cholecystectomies in Motala Hospital, the best comparison would be 3.5 days for patients with in-hospital stay in Motala versus 4.1 for Sweden. However, the main message of the report is that open cholecystectomy and concomitant removal of bile duct stones, should be considered a cost-effective alternative in a unit with emergency service and trainee surgeons, provided small-incision surgery is aimed for.

We agree totally with Dave Hopkins that the incision should be as wide as safety requires. And furthermore, trainees should be assisted by senior colleagues during critical moments in all gallbladder surgery.
For the authors,
Erik Nilsson, M.D., Ph.D.

1. Rosenmuller M, Haapamaki MM, Nordin P, Stenlund H, Nilsson E: Cholecystectomy in Sweden 2000-2003: a nationwide study on procedures, patient characteristics, and mortality. BMC Gastroenterol 2007, 7:35.

Competing interests

The authors declare that they have no competing interests.


Field Restriction

Dave Hopkins   (2006-04-25 11:29)  other email

The only possible contraindication to an open small incision cholecystectomy is that an unexperienced surgeon may be impacted by the limited range of the field. However, seeing as many of these cases were elective cases, unexperienced surgeons probably did not perform them. Looking at this scenario from the perspective of a busy Emergency Department, I would have to say that during a time of increased patient flow or heavy trauma, a case like this would be deemed a non-life-threatening emergency and would most likely be handed off to a less experienced surgeon. This could result in extreme morbidity or mortality in a severe case. This is a very unusual situation and may never occur. But, this is a subject and scenario that could possibly be postulated before such a scenario became standard procedure.

Competing interests

None declared


Post a comment