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Open mini-invasive cholecystectomy in high risk elderly. A review of 121 consecutive procedures
G Amato1, G Salamone, G Romano
1University of Palermo, Italy.
Introduction:
the report describes the features of a low cost, open mini-invasive procedure for cholecystectomy in a sample of 121 consecutive high risk elderly (ASA score 3 to 5).
Patients And Methods:
the surgery is performed through a 3 - 4 cm right subcostal skin incision. An optimal exposition of the operating field was achieved thanks to an innovative three valve retractor.
Results:
a mean hospital stay of 3,02 days, low complication rate and 2,4% mortality are the results of the described procedure.
Conclusions:
in high risk elderly the results are extremely encouraging, particularly in comparison with both laparoscopic and traditional open cholecystectomy. The open minisurgical cholecystectomy could be considered a cost-effective alternative to laparoscopy, with excellent results in this subset of patients. The described mini-surgical procedure can also integrate the laparoscopic in case of conversion.