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Mini-laparotomy cholecystectomy versus laparoscopic cholecystectomy: which way to go?
Konstantinos Vagenas1, Panagiotis Spyrakopoulos, Menelaos Karanikolas
1Department of General Surgery, University of Patras School of Medicine, Patras, Greece. kvagenas@hotmail.com
Purpose:
The aim of this paper is to report the results of a prospective clinical trial investigating traditional laparoscopic cholecystectomy versus "mini-lap" cholecystectomy in a tertiary care University Hospital.
Materials And Methods:
This is a prospective, randomized, single-center observational study. Forty-four patients were allocated in each group; patients in group L underwent laparoscopic cholecystectomy, whereas patients in group M had open "mini-laparotomy" cholecystectomy with a small incision through the rectus abdominis muscle.
Results:
The operation lasted significantly longer in group L compared with group M, whereas patients of group L had a shorter hospital stay. There was no difference between groups regarding postoperative day on which patients commenced eating. There was no significant difference between groups regarding doses of analgesics used during surgery or in the recovery room. However, patients in group M used significantly more opioids in the postoperative period. Time to resume normal activity was significantly shorter in group L. A very good aesthetic result was obtained in 97.7% of patients in group L and 77.3% of patients in group M.
Conclusions:
Cholecystectomy through a mini-laparotomy incision is a lower-cost, versatile, and safe alternative to laparoscopic cholecystectomy.