Micro- and modern minilaparotomy cholecystectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Gastrointestinal Surgery

Background:

• Minilaparotomy cholecystectomy (MLC) definitions vary, impacting surgical practice.
• Standardizing definitions for MLC, modern MLC (MMLC), and conventional MLC (CMLC) is crucial.
• Developing alternatives to laparoscopic cholecystectomy (LC) and conventional cholecystectomy (CC) is an ongoing surgical goal.

Purpose of the Study:

• To present surgical experiences with microlaparotomy cholecystectomy (MLC) and modern minilaparotomy cholecystectomy (MMLC).
• To evaluate MLC and MMLC as alternatives to laparoscopic cholecystectomy (LC) and conventional cholecystectomy (CC).
• To define and compare different lengths of minilaparotomy incisions for cholecystectomy.

Main Methods:

• Retrospective analysis of 607 patients undergoing MLC and MMLC.
• Categorization of incisions: MLC (<4 cm), MMLC (4.1–6 cm), CMLC (6.1–10 cm).
• Evaluation of patient demographics, case complexity, and outcomes including complications and reoperations.

Main Results:

• A total of 607 patients (435 female, 172 male) underwent MLC/MMLC.
• Low rates observed: 0.16% death, 0.49% early reoperation, 0.49% conversion.
• Most complications occurred in the delayed group, particularly in obstructive cholecystitis cases.

Conclusions:

• MLC and MMLC are safe and effective alternatives to LC and CC.
• These procedures do not require specialized skills or expensive technology, enhancing accessibility.
• MLC and MMLC present less expensive surgical options for cholecystectomy in general hospitals.