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Open cholecystectomy: muscle splitting versus muscle dividing incision: a randomized study
P E Baguley1, C J de Gara, N Gagic
1Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1995
Summary
For patients needing open cholecystectomy, a muscle-splitting incision significantly reduces postoperative pain and improves mobility compared to traditional muscle-dividing techniques. This approach is recommended for better patient recovery.
Area of Science:
- Surgical techniques
- Gastrointestinal surgery
- Pain management
Background:
- Laparoscopic cholecystectomy is standard for symptomatic gallstones, but 10% of patients require open cholecystectomy.
- Postoperative wound pain is a significant factor in morbidity after open cholecystectomy.
- Smaller incisions have reduced hospital stays, but pain remains a concern.
Purpose of the Study:
- To compare the pain and mobility outcomes of muscle-splitting versus muscle-dividing incisions in open cholecystectomy.
- To evaluate the effectiveness of different surgical approaches for reducing postoperative morbidity.
Main Methods:
- A randomized consecutive study comparing muscle-splitting and muscle-dividing incision techniques for open cholecystectomies.
- Pain was assessed using the short form of the McGill pain questionnaire.
- Patient mobility was evaluated on postoperative days 1 and 2.
Main Results:
- The muscle-splitting technique resulted in significantly less pain (P < 0.001) compared to the muscle-dividing technique.
- A significantly higher proportion of patients in the muscle-splitting group were fully mobile on postoperative days 1 and 2.
- No statistically significant difference in analgesia requirements was observed between the groups.
Conclusions:
- The muscle-splitting incision technique is superior to the muscle-dividing technique for reducing pain and improving early mobility after open cholecystectomy.
- This technique should be considered when open cholecystectomy is necessary.
- Implementing muscle-splitting incisions can enhance patient recovery and reduce postoperative morbidity.