Limited incision cholecystectomy

Eighty-one consecutive cholecystectomies were retrospectively reviewed; five were dropped because of incomplete data. The remaining 76 were divided into group A, patients who underwent a limited incision cholecystectomy (LIC) defined as less than 10 centimeters, and group B, those who underwent a standard subcostal incision (STD). An STD was used for 18 patients in 1984 and an LIC for subsequent patients unless anatomy dictated extension of the incision for safe surgical exposure. The groups were evaluated for possible benefits and disadvantages of the LIC approach. Multivariate analysis was done to contrast the approaches regarding operative time, operative and postoperative complications, postoperative pain, and hospital stay. The operative time was comparable between the two groups. The LIC approach was superior with less postoperative pain and shorter hospital stay. There were no intraoperative complications or mortality in either group. The postoperative complications were also comparable. No differences were noted in body size, weight, sex, or whether the patient was suffering from acute or chronic disease. The limited incision cholecystectomy can be utilized in the majority of patients with cholecystitis without added operative time or complications when compared to the traditional approach. The benefits of less postoperative pain, shorter hospital stay and better cosmetic results afford a higher degree of patient acceptance. This procedure should be considered when open cholecystectomy is required.