This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Elective transumbilical compared with standard laparoscopic cholecystectomy.
OBJECTIVE To compare the transumbilical technique of laparoscopic cholecystectomy with st and ard laparoscopic cholecystectomy . DESIGN R and omised open study . SETTING Teaching hospital , Italy . SUBJECTS 90 patients who required elective cholecystectomy under general anaesthesia . INTERVENTIONS St and ard laparoscopic cholecystectomy through 4 ports or transumbilical cholecystectomy through 2 ports . MAIN OUTCOME MEASURES Amount of pain and analgesia , cost , side effects , and cosmesis . RESULTS 25 patients were excluded from analysis ( 8 in the st and ard group because relevant data were not recorded ; and 17 in the transumbilical group in 4 of whom relevant data were not recorded , and 13 for technical reasons ) . 32 patients who had st and ard  , and 25 who had transumbilical cholecystectomy had operative cholangiograms . There were no complications , no side effects , and no conversions to open cholecystectomy . Those who had transumbilical cholecystectomy had significantly lower pain scores ( p<0.05 ) and required significantly less analgesia during the first 24 hours ( p<0.05 ) than those who had st and ard laparoscopic cholecystectomy . CONCLUSION Once the learning curve has been completed , transumbilical cholecystectomy is possible without some of difficulties associated with st and ard laparoscopic cholecystectomy
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .