Ugeskrift for laeger
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Ugeskrift for laeger · Jun 2005
[Effect of laparoscopic cholecystectomy on the quality of life of patients with uncomplicated socially disabling gallstone disease].
The indication for cholecystectomy in symptomatic, uncomplicated gallstone disease varies in the literature, and there is no international consensus. In Denmark, laparoscopic cholecystectomy is recommended for patients with uncomplicated cholecystolithiasis and socially disabling pain. Postoperative health-related quality of life on this indication is unknown. ⋯ Laparoscopic cholecystectomy improves the health-related quality of life six weeks after the operation in patients with socially disabling, uncomplicated cholecystolithiasis.
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The characteristics of early pain after laparoscopic cholecystectomy are complex and should be treated in a multimodal fashion. A critical procedure-specific analysis of the evidence suggests a prophylactic analgesic regimen including routine use of preoperative steroids, incisional local anaesthetics and NSAIDs (or COX2-inhibitors) combined with paracetamol for three to four days. Minor modifications of surgical techniques (low insufflation pressure and downsizing of trocars) and preoperative information about the characteristics of early pain after laparoscopic cholecystectomy will add further analgesic benefits to the regimen.