Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

Abstract

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as ad ay surgery procedure.Patients and Methods: Thirty electives ymptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27-68), the mean body mass index 29 kg/m 2 (range 19-41). Gallstones were confirmed with ultrasound and the preoperative liver laboratory tests were normal in all patients. Afive (+/-2)centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter.Results: The average operating time was 51 minutes (range 30-105 minutes). Day surgery was possible in 25 cases(83%).Fivepatients (17%) stayedover nightatthe hospital. There were four (13%) conversions to conventional cholecystectomy.T he average postoperative sick leave was 16 days (range 14-30).T wo patients returned to hospital. One patienthad wound pain,but no complicationwas found, andthe patientwas notadmitted. One patient had aw ound infection and spent6d ays in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients.Conclusions: The results of this study support the suitability of MC as aday surgery procedure, but aprospective randomised trial is needed to evaluate the relative advantages of MC and LC.

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 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.…”

A prospective, randomized multicenter study comparing conventional laparoscopic cholecystectomy versus minilaparotomy cholecystectomy with ultrasonic dissection as day surgery procedure—1-year outcome

“…LC is the preferred management for symptomatic gallstones and is increasingly carried out as a day-surgery procedure in order to decrease hospital-acquired infections, allow patients an earlier return to normal activities and save costs. Several studies indicate that MC may also be performed successfully on a day-case basis [1,[19][20][21][22][23][24][25]. Outcome-studies considering overnight-stay patients indicate that LC and MC could both be feasible techniques for elective cholecystectomy [3][4][5][6][7][8][9][10][11][12][13].…”

Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy

“…The MC technique is open mini-invasive technique with very short wound [mean (SD) length of skin incision, 4.8 (1.0) cm], and the rectus muscle was split, not cut in the MC technique. Cutting the rectus muscle or a skin incision longer than 7 cm was considered as a conversion to a conventional open operation in the MC group [13][14][15][16][17][18]. At the end of the operation, the wounds were infiltrated with local anesthetic (20 ml ropivacaine 7.5 mg/ml) in both groups.…”