MINILAPAROTOMY CHOLECYSTECTOMY

Recent randomized studies have shown that laparoscopic cholecystectomy has little or even no advantage when compared to minilaparotomy chole cystectomy. The authors report the results of a prospective study of m inilaparotomy performed at Dahr el Bacheq governmental hospital where laparoscopic equipment was not available. From July 1994 to July 1997 minilaparotomy cholecystectomy was performed on one hundred consecutiv e patients (75 women and 25 men with an age varying between 26 and 93 years). However, the cholecystectomy could be accomplished through the miniincision in only 88 cases. Lengthening of the incision was necess ary in 12 cases : common duct stones (8 cases), cancer (2 cases), chol ecystoduodenal fistula (2 cases). Intraoperative cholangiography was n ot performed in 3 cases: very thin cystic duct (2 cases), technical pr oblem(1 case). Two patients operated for acute cholecystitis had wound infection. Postoperative course of the 88 completed minilaparotomy ch olecystectomies was uneventful : no mortality, no biliary complication s, little pain with low analgesia requirement, oral intake on day 1, d ischarge from hospital on day 2, return to normal activity between day 8 and day 14. Results of minilaparotomy cholecystectomy compare favor ably with those of laparoscopic cholecystectomy. It should be an alter native to laparoscopic cholecystectomy especially when cost is a probl em or when laparoscopic equipment is not available and an alternative to conventional open cholecystectomy in the case of contraindication t o laparoscopic cholecystectomy.