MINI-CHOLECYSTECTOMY: A FEASIBLE OPTION

Authors

  • Nadia Saeed
  • Tauqeer Nasir
  • Bilal Burki
  • Ghulam Asghar Channa

Abstract

Background: In standard or conventional cholecystectomy gallbladder is approach through asubcostal incision of 7–10 Cm. New technique and procedures have evolved, aiming at decreasedtissue damage, pain, hospital stay and complications. This study was conducted to assesscholecystectomy through 5 Cm mini-laparotomy. Methods: This study was conducted atDepartment of General Surgery, Ward-26, Jinnah Postgraduate Medical Centre, Karachi fromJanuary, 2008 to January, 2009. Both sexes irrespective of age were included in this study. Ninetycases were females and 10 were male. Mean age of the patients was 48 years. Minicholecystectomy was performed on patients and results evaluated as percent and frequency.Results: This study included 100 patients with cholelithiasis. Mini-cholecystectomy was possiblein 95% cases, and in 5 cases incision had to be extended to conventional cholecystectomy. Theaverage operating time was 50 minutes and postoperative hospital stay was 2-days andpostoperative complications like minor biliary leak, haemorrhage and wound infection was seen in10 cases. Conclusion: Mini-cholecystectomy is a safe procedure with shorter operative time,fewer complications, better prognosis, and less of postoperative hospital stay. It may berecommended as a procedure of choice where laparoscopic facilities are not available.Keywords: Gallbladder, Cholelithiasis, Mini-cholecystectomy, Mini-laparotomy

References

Gilliland TM, Traverso LW. Modern standard of comparison

of cholecystectomy with alternative treatment of

symptomatic cholelithiasis with emphasis on long term relief

of symptoms. Surg Gynacol Obstect 1990;170:39–40.

Traverso LW. Clinical manifestation and impact of gall-stone

diseases. Am J Surg 1993;165:405–8.

Langenbuch C, Ein fall von Extirpation der Gall blasé wagen

chronischer. Berlinerklin Wochenschr 1882;19:725–7.

Garcia-valdecasas JC, Almenara R, Cabrer C, de Lacy AM,

Sust M, Taurá P, et al. Subcostal incision versus midline

laparotomy in gall stone surgery: a prospective randomized

trial. Br J Surg 1988;75:473–5.

Dubois F, Berthelot G, Levard H. Cholecystectomy par

coellospie (Cholecystectomy by coelioscopy). Presse Med

;18:980–2.

O’Dowyer PJ, Murphy JJ, O’Huggins NJ, Cholecystectomy

through 5 cm subcostal incision. Br J Surg 1990:77;1189–90.

Ledet WP Jr. ambulatory cholecystectomy without disabilityArch Surg 1990:125;1434–5.

Deziel DJ, Millikan KW, Economou SG, Doolas A, KO ST,

Airan M. Complications of laparoscopic cholecystectom; a

national survey of 4,292 hospitals and analysis of 77,604

cases. Am J Surg 1993;165:9–14.

Ros A, Gustafsson L, Krook H, Nordgren CE, Thorell A,

Wallen G, Nilsson E. Laparoscopic cholecystectomy versus

mini-laparotomy cholecystectomy A prospective,

randomized, single-blind study. Ann Surg 2001;234:741–9.

Sharma AK, Rangan HK, Choubey RP. Mini-lap

cholecystectomy: a viable alternative to laparoscopic

cholecystectomy for the third world? Aust NZ J Surg

;68:774–7.

Tate JJ, Lau WY, Leung K L, LI AK. Laparoscopic versus

mini-incision cholecystectomy. Lancet 1993:341:1214–5.

Rozos I, Frenczy J, Schmitz R. Micro and minicholecystectomies in the 21st century. Orv Hetil

;144:1291–7.

Ahmad A, Khan HM, Gulshan S, Shah TA. Mini

cholecystectomy: A comparison with laparoscopic

cholecystectomy: Ann King Edward Med Uni 2005;11:387–8.

Seale AK, Ledet JR. Minicholecystectomy a safe, cost effective

Day Surgery Procedure. Arch Surg 1999;134:308–9.

Thomas S, Singh J, Bishnoi PK, Kumar A. Feasibility of day

care open cholecystectomy, evaluation in an inpatient model.

ANZ J Surg 2001;71:93–7.

Merril JR. Minimamal trauma cholecystectomy (a no touch

procedure in a well) Am J Surg 1998;54:256–7.

Oslen DO. Minilap cholecystectomy Am J Surg

;165:440–3.

Al-Tameem MM. Mini-lap cholecystectomy. J R Coll Surg

Edin 1993;38:154–7.

McMohan AJ, Russell IT, Baxter JN, Ross S, Anderson JR,

Morran CG, et al. Laparoscopic versus minicholecystectomy,

a randomized trial. Lancet 1994;343:135–8.

Tangjareon S, Watanapa P. Minicholecystectomy under local

anaesthesia. Asian J Surg 2007;30:235–8.

Schmitz R, Rohde V, Treckmann J, Shah S. Randomized

clinical trial of conventional cholecystectomy versus mini

cholecystectomy Br J Surg 1997;84:1683–6

Majeed AW, Troy G, Nicholl JP, Smythe A, Reed MW,

Stoddard CJ, et al. Randomized, prospective, single-blind

comparison of laparoscopic versus small incision

cholecystectomy. Lancet 1996;347:989–94.

Ahmad QJ, Gulfam MA, Noorani SM, Khan NF. Ten years

experience on mini-cholecystectomy versus ten years

experience of conventional cholecystectomy at K.V.S.S. site

hospital, Karachi. Pak J Surg 2004;20:8–10.

Khan N, Haleem A, Ahmed I, Jan A. Cholecystectomy

through minilaparotomy incision, Gomal J Med Sci

;7:92–5.

Amir M, Haider R. Mini-open chlecystectomy in the

management of cholelithiasis .J Coll Physicians Surg Pak

;17:269–71.

Bhutta A, Ahmad F, Khan S, Haq A. Mini cholecystectomy:

an alternative procedure for cholelithiasis. Pak Post grad Med

J 2001;12(3):85–90.

Published

2010-09-01

Issue

Vol. 22 No. 3 (2010): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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