Cholecystectomy through Mini Laparotomy Incision

Abstract

Background: In standard cholecystectomy gall bladder is approached through a subcostal incision of 7-10cm. New techniques and procedures have evolved, aiming at decreased tissue damage, pain, hospital stay, and complications. This study was conducted to assess cholecystectomy through 5cm mini laparotomy.

Material & Methods: This descriptive study was conducted at department of Surgery Khyber Teaching Hospital Peshawar from January 2002 to December 2002. The trial was open to both sexes irrespective of age and duration of illness. Both, acute & chronic cholecystitis were included. Ninety were females, 10 were males. Mean age was 48 years. Ninety patients had chronic cholecystitis, 5 had acute cholecystitis, and 5 had mucocele of the gall bladder. Close drains were placed in 6 cases. Post operative ultrasound was performed in all these cases specially for the intra and extra hepatic billiary passages and condition of the liver.

Results: The study included 100 patients with cholelithiasis. Cholecystectomy through 5cm subcostal incision was possible in 90 cases. In 10 cases anatomical landmarks could not be identified satisfactorily through 5cm incision and it had to be extended. The average operating time was 50 minutes and average blood loss was 100ml. The average post-operative hospital stay was 2 days. Sub-hepatic collection developed in only one patient.

Conclusion: Cholecystectomy through minilaparotomy is a safe procedure with shorter operating time, fewer complications, better cosmesis and less post-operative stay. It may be recommended as a procedure of choice where laparoscopic facilities are not available.