Small-incision Open Cholecystectomy or Laparoscopic Cholecystectomy for Gallbladder Disease

April 23, 2015 updated by: Umeå University

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

355

Phase

  • Phase 2
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Sweden
    • Västerbotten
      • Lycksele, Västerbotten, Sweden
        • Lycksele Hospital
      • Umeå, Västerbotten, Sweden, SE 90185
        • Department of Surgery and Perioperative Sciences, Umeå University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Cholecystectomy is considered the best available treatment.
  2. The patient understands trial information and is capable of making a decision after having received information.
  3. The patient wants to undergo cholecystectomy and accepts participation in the trial.

Exclusion Criteria:

  1. Age below 18 years.
  2. The patient is unable to understand trial information.
  3. Competence for both trial groups are lacking when a patient is randomized.
  4. The cholecystectomy is part of a more extensive operation (e.g., pancreaticoduodenectomy).
  5. The indication of cholecystectomy is proven or suspected cancer of the gallbladder.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Laparoscopic cholecystectomy
Operation by experts in laparoscopy.
Procedure: Laparoscopic cholecystectomy
Operation by experts in laparoscopy. The operation may be performed as laparoscopic or converted to an open operation.
Active Comparator: Small-incision open cholecystectomy
Operation by experts in small-incision cholecystectomy.
Procedure: Small-incision open cholecystectomy
Operation by experts in small-incision open cholecystectomy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Health-related quality of life, postoperative pain, and health care costs.
Time Frame: Three, seven, eleven, and 30 postoperative days and one year after the operation.
Three, seven, eleven, and 30 postoperative days and one year after the operation.

Secondary Outcome Measures

Outcome Measure
Time Frame
Compliance to evidence-based recommendations for treatment of gallstone complications, postoperative complications, operation time, hospital time, and sick leave.
Time Frame: Thirty days and one year after the operation.
Thirty days and one year after the operation.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Umeå University

Collaborators

Norrlandstingens Regionförbund

Investigators

  • Principal Investigator: Mats Rosenmüller, MD, Umeå University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2006

Primary Completion (Actual)

April 1, 2011

Study Completion (Actual)

November 1, 2011

Study Registration Dates

First Submitted

August 30, 2006

First Submitted That Met QC Criteria

August 30, 2006

First Posted (Estimate)

August 31, 2006

Study Record Updates

Last Update Posted (Estimate)

April 24, 2015

Last Update Submitted That Met QC Criteria

April 23, 2015

Last Verified

April 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • GANO-05-147M

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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