Feasibility of Minilaparotomy versus Laparoscopic Cholecystectomy for Day Surgery: A Prospective Randomised Study

Abstract

both MC and LC are feasible surgical techniques for day surgery. However, appropriate prevention and prompt management of established postoperative nausea and vomit-ing and careful patient selection are important aspects for success of short-stay approach. If there is a sign of chronic cholecystitis preoperatively, it might be considered as a contraindication for day surgery.

A randomized multicenter study of minilaparotomy cholecystectomy versus laparoscopic cholecystectomy with ultrasonic dissection in both groups

“…The minilaparotomy cholecystectomy has shown to have a similar perioperative course than the LC and follow-up results on early postoperative recovery indicates that these two techniques share a similar short-term recovery [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. We described earlier the accuracy of ME in the MC versus the LC [27,28] and our results suggest a relatively similar 5-year and 10-year outcome after the MC and the LC [29,30].…”

“…The rectus muscle was split, not cut in the MC technique. The cutting the rectus muscle or a skin incision longer than 7 cm in the MC group was considered to be a conversion to conventional open operation [20,24,27]. At the end of the operation, the wounds were infiltrated with local anaesthetic (20 ml ropivacaine 7.5 mg/ml) in both groups.…”

“…The secondary outcome measures were the operation time (minutes), length of the skin incision (cm), nausea and vomiting and other complications, and the need to contact the hospital or other health care providers after the discharge. The sample size calculation was based on the assumption that the convalescence should be 16 days (SD 4) in the LC group [20,24,27]. In order to show a 3-day difference in the convalescence between the two groups, 40 patients per group were required at a study power of 0.9 and twosided alfa-level of 0.05 to show a statistically significant difference between the groups.…”

“…The laparoscopic technique is the golden standard of cholecystectomy although cholecystectomy by minilaparotomy (MC) has shown to lead to as good early recovery after surgery [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. We have earlier done a study where we assessed the MC with UsD versus the LC with ME.…”

Gallbladder Surgery, Choice of Technique: An Overview

“…Both small-incision cholecystectomy (6,7,14,17,(50)(51)(52) and laparoscopic cholecystectomy (50,(52)(53)(54)(55)(56) are compatible with ambulatory surgery. A Cochrane review has considered laparoscopic day-case surgery safe and effective for selected patients with symptomatic cholelithiasis (57).…”