Mini‐cholecystectomy: a personal series in acute and chronic cholecystitis

Watanapa, P.

doi:10.1080/13651820310001379

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…31,32 After the introduction of laparoscopy during the 80s and in 1985, LC has overtaken open surgery for cholelithiasis as a technological revolution even though smaller incision open cholecystectomy, introduced in early 1982 had shown successful outcome with a shorter convalescence. 4,5,33 Open cholecystectomies have stayed and are performed with a less cost, the need of equipment, and training. [1][2][3][4][5][6][7] comparing conventional OC and LC continue to unfairly One patient had a subtotal cholecystectomy.…”

Section: Resultsmentioning

confidence: 99%

“…4,5,33 Open cholecystectomies have stayed and are performed with a less cost, the need of equipment, and training. [1][2][3][4][5][6][7] comparing conventional OC and LC continue to unfairly One patient had a subtotal cholecystectomy. Separation of adhered omentum revealed a thick wall friable GB with necrosis at the fundus.…”

Section: Resultsmentioning

confidence: 99%

“…Cholecystectomy for symptomatic gallstones using mini-incision cholecystectomy (MC) introduced in the invasive surgery (MIS) in line with the enhanced recovery after surgery (ERAS). [1][2][3][4][5] Use of muscle-splitting incision has shown to further reduce trauma. 2,6,7 Spinal anesthesia compromise pulmonary function and peri-operative events due to neuroendocrine stress encountered in general anesthesia (GA).…”

Section: Introductionmentioning

confidence: 99%

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Muscle-splitting mini-incision cholecystectomy under spinal anesthesia: cost-effective equitable minimally invasive surgery in laparoscopy era

Shah

Mandal²,

Shah³

et al. 2021

J. Soc. Surg. Nepal

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Introduction: Conventional open cholecystectomy has been increasingly replaced by laparoscopy which requires resources for expensive equipment, training, and maintenance. Muscle-splitting mini-incision cholecystectomy under spinal anesthesia has comparable outcomes to laparoscopy and requires fewer resources. This study analyzes the feasibility and outcome of muscle-splitting mini-incision cholecystectomy under spinal anesthesia. Methods: All consecutive cases of muscle-splitting mini-incision cholecystectomy (MC) performed for symptomatic cholelithiasis during three years ending in December 2019, at a periphery hospital in Janakpur, province-2, Nepal, were included. Complicated cholelithiasis (biliary pancreatitis, jaundice, cholangitis, dilated common bile duct) was excluded. Written informed consents were obtained. The need for general anesthesia, complications during and after surgery, and patient satisfaction were analyzed descriptively. Ethical approval was obtained. Results: Out of 148 MC completed under spinal anesthesia, six (4.1%) required fentanyl for shoulder discomfort. Mild post-operative pain was reported by 124 (83.8%) at six hours and 146 (98.6%) at 12 hours. The intravenous drip was stopped after surgery and oral liquid with analgesics started in two hours in 143 patients (96.6%). Post-operative antibiotic was given in nine, for 2(1.4%) cholecysto-duodenal fistulas, 4(2.7%) diabetics, and 3(2%) mucoceles. The mean hospital stay was one night. Wound complications occurred in 6(2.8%). Overall, 144 (97.3%) were satisfied and would recommend the procedure to others. Histopathology revealed adenocarcinoma in one case. There was no bile-duct injury, re-surgery, or mortality. Conclusion: Muscle-splitting mini-incision open cholecystectomy (MC) under spinal anesthesia is safe and effective with early feeding, short hospital stays, less demand for resources, and good patient satisfaction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Muscle-splitting mini-incision cholecystectomy under spinal anesthesia: cost-effective equitable minimally invasive surgery in laparoscopy era

Shah

Mandal²,

Shah³

et al. 2021

J. Soc. Surg. Nepal

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“…More than 2,000 cases of Mini-Cholecystectomy (MC) have been reported worldwide without any deaths or major common bile duct injuries since the first report in 1982. (1)(2)(3)5,(7)(8)(9)(10)(11)(12) Although three randomized controlled trials showed better results for Local anesthesia (LC)…”

Section: Discussionmentioning

confidence: 99%

“…(5)(6)(7)(8) More recently, Mini-Cholecystectomy (MC) has been shown to be an effective surgical procedure for an inflamed gallbladder regardless of the degree and type of inflammation. (9) Both Mini-Cholecystectomy (MC) and laparoscopic Cholecystectomy(LC) are usually performed under general anesthesia. However, it is likely that in suitable patients or in those who are unwilling to have general anesthesia or have severe contraindications to narcosis, the gallbladder can be excised under local anesthesia through a very small incision.…”

Section: Introductionmentioning

confidence: 99%

Mini-Cholecystectomy under Local Anesthesia for Symptomatic Gallstone Patients Unfit for General Anesthesia

Mohammed

2015

Kufa Jour. Nurs. Sci.

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Background:: Reports of open-Cholecystectomy (OC) or laparoscopic Cholecystectomy (LC) under general anesthesia (GA) in the surgical treatment of gallbladder disease are common, but those performed under local anesthesia (LA) are much more limited, especially for old aged patients unfit for GA. Objectives: This study try to show that Mini-Cholecystectomy (MC) under LA for symptomatic gallstone disease is safe and effective in old aged patients, unfit for GA. This study tried to determine the safety and success of Mini-Cholecystectomy under local anesthesia for symptomatic gallstone disease in old aged patients unfit for GA. Methodology: ninety patients with gallstone disease scheduled for Mini-Cholecystectomy under local anesthesia were included in this prospective study in Erbil teaching hospital and sardam private hospital. Seventy-three patients were female, with a median age of 70 years (range, 50-90). All of the patients had evidence of acute cholecystitis. Mini-Cholecystectomy MC was performed by a standardized technique and under the combination of local anesthesia (1% zylocain without adrenaline) and intravenous administrations of fentanyl (0.001-0.002 mg/kg) and midazolam (0.05-0.1 mg/kg). Statistical analyses were performed using Microsoft Word Excel 2007. Results: The median operative time was 45 minutes (range, 35-70). Local anesthesia was converted to general anaesthesia in seven patients owing to the severe discomfort caused by lysis of dense adhesions around the gallbladder, giving a success rate of 95.5%. Cholecystectomy was done successfully in 65(72.22%) patients, while cholecystostomy was performed in the remaining 25 (27.77%) patients because of the severe adhesions that rendered Cholecystectomy very difficult. The median hospital stay was 2.6 days (range, 2-7). Conclusions: Mini-Cholecystectomy (MC) under Local anesthesia (LA) is an effective surgical procedure for old aged patients with acute calculus cholecystitis who are unfit for GA. Recommendation: It is recommended to study a larger sample for long period to evaluate the late complications of the operation.

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Mini-lap cholecystectomy: Modifications and innovations in technique

Chalkoo

Ahangar

Durrani

et al. 2010

International Journal of Surgery

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These results confirm that mini-lap cholecystectomy by our modified approach is safe, feasible and has lesser morbidity and postoperative pain as compared to conventional open cholecystectomy. The technique is cost effective, easy to practice and can benefit majority of patients who otherwise cannot afford the laparoscopic surgery. Hence it can serve as an alternative to the gold standard laparoscopic cholecystectomy with almost comparable results.

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Mini‐cholecystectomy: a personal series in acute and chronic cholecystitis

Abstract: MC is an effective surgical procedure for an inflamed gallbladder regardless of the degree and type of inflammation. Patients with chronic cholecystitis recover more quickly and have a shorter hospital stay.

Cited by 8 publications

References 22 publications

Muscle-splitting mini-incision cholecystectomy under spinal anesthesia: cost-effective equitable minimally invasive surgery in laparoscopy era

Muscle-splitting mini-incision cholecystectomy under spinal anesthesia: cost-effective equitable minimally invasive surgery in laparoscopy era

Mini-Cholecystectomy under Local Anesthesia for Symptomatic Gallstone Patients Unfit for General Anesthesia

Mini-lap cholecystectomy: Modifications and innovations in technique

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