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Needlescopic versus laparoscopic cholecystectomy. A prospective study of 60 patients
Pedro Henrique Oliveira Cabral1, Ivan Tramujas da Costa e Silva, Janaína Vieira Melo
1Santa Casa de São Paulo, Medical Sciences Faculty, Brazil.
Purpose:
To test the hypothesis that needlescopic cholecystectomies (NC) offer superior outcomes in comparison to common laparoscopic cholecystectomies (LC).
Methods:
Sixty consecutive patients with gallbladder disease undergoing either LC or NC were evaluated with respect to differences in operative time, frequency of per-operative incidents, post-operative pain, late postoperative symptoms, length of scars and level of postoperative satisfaction.
Results:
Mean operative time was similar in both groups. Most of the patients, irrespective of the technique, informed mild postoperative pain. NC patients had lower levels of pain on the 7th postoperative day (PO7) (p<0.01) and decreased need for additional analgesia. Less frequency of epigastric wound pain was observed in NC patients until PO4 (p<0.01). Aesthetic result was far superior after NC (total length of scars less than half after LC). No differences regarding postoperative satisfaction with the operation were observed between the studied groups.
Conclusions:
Both techniques were safe and effective, presenting similar operative times and low levels of postoperative pain. Downsizing the ports to 2-3 mm was associated with significantly less frequency of postoperative pain only in the epigastric wound until PO4. Aesthetic outcome of NC was significantly superior to LC, although this advantage did not influence patient level of satisfaction.
