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Minilaparotomy cholecystectomy--an appropriate alternative to laparoscopic cholecystectomy in developing nations
Vijay Naraynsingh1, Yardesh Singh, Tamara Remy
1Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad, West Indies.
Background:
This study reports the experience of performing minilaparotomy cholecystectomy (MC) and assesses the peri-operative outcome of this surgery in the setting of a developing country.
Methods:
Data of all patients who underwent minilaparotomy cholecystectomy by a single surgical unit were collected and reviewed. These included demographics, surgical technique used, peri-operative complications and length of hospital stay. Descriptive analyses were done.
Results:
476 patients who underwent elective minilaparotomy cholecystectomy in a single surgical unit over a 15 year period were studied. Of these, 84.8% were female. The mean age was 47 years. The most common indication for surgery was symptomatic cholelithiasis with chronic cholecystitis (66%). Mean length of the surgical incision was 4.8 cm and mean operating time was 31 min. Rate of conversion to conventional open cholecystectomy was 4%. Median hospital length of stay was 22 hours. Minor wound infection was the only surgical post-operative complication recorded in 7 patients. Nine patients in the converted group and 3 in the minilaparotomy cholecystectomy group had significant vomiting. There was no mortality.
Conclusion:
The study reinforces the view that minilaparotomy cholecystectomy can be safely and effectively performed with minimal peri-operative complications, and is ideal for developing country settings.