Minilaparotomy cholecystectomy

Cholecystectomy was performed through a 3-5 cm minilaparotomy incision in 80 consecutive patients with stones confined to the gall bladder, with 97.5% success rate. The procedure was converted to the conventional method in two (2.5%) patients only, both with chronic empyema of the gall bladder. The mean operation time was 36 min. Cholecystectomy through this mini-exposure was facilitated by the use of an illuminated retractor and a metal clip applicator. There was no mortality or major duct injury in this series. Choleperitoneum occurred, early in the series, in two (2.5%) patients and was treated successfully by percutaneous aspiration and temporary stenting of the sphincter of Oddi. Minor complications occurred in 10 patients (12.5%). Ninety per cent of patients were ready for discharge within 2 days of their surgery and 80 were fit to return to work within 10 days. Compared with laparoscopic cholecystectomy, the minilaparotomy approach, similarly, offers the patient an improved cosmetic result, shorter hospitalization and early return to work. Moreover, minilaparotomy cholecystectomy has the advantages of a much shorter operation time and probably a smaller risk of major complications. In addition it does not require sophisticated expensive technology or additional specialized skills and, therefore, can become available in any general hospital.