MINILAPAROTOMY CHOLECYSTECTOMY VERSUS LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE RANDOMIZED STUDY | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 32, Issue 3, July 2013, Page 214-218 PDF (230 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2013.366734 | ||||
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| Authors | ||||
| Mahmoud Abdelhameid Mahmoud* ; Mohammed Khalil Elammary; Hamdy M Hussein | ||||
| General Surgery Department, Qena University Hospital, South Valley University | ||||
| Abstract | ||||
| Background and Aim: Minilaparotomy cholecystectomy (MC) and laparoscopic cholecystectomy (LC) are commonly applied surgical techniques in the management of non-complicated symptomatic gallstone disease. We compared both MC and LC in a randomized trial. Patients and Method: Forty three patients underwent LC were compared to forty five patients who underwent MC (It is defined in this study as open cholecystectomy through incision less than 8 cm length). The items of comparison were operative duration, operative and post-operative complications and success of the procedure as one day surgery. Results: Both groups were comparable as regarding age, sex, BMI and ASA status. The operation time was statistically significant shorter for MC group when compared to LC group (P= 0.001). In LC group; 2 patients out of 43 patients (4.65%) were converted into the classic open method (one patient was due to massive adhesion in the area of Calot’s triangle and the second patient was due to injury of CBD), while in MC group; 3 cases out of 45 cases (6.67%) required a more generous incision to use larger retractors to obtain a clearer view of Calot’s triangle. The hospital stay for the LC group ranged between 12-24 hrs which is shorter than the 1-2 days of the MC group. There were no significant late postoperative complications apart from 3 cases of superficial surgical site infections among LC group and 2 cases among the MC group. LC was successful as one day surgery in 40 patients out of 43 patients (the failure were due to; CBD injury and patients couldn't tolerate oral fluid intake due to post-operative nausea and vomiting not respond to the ordinary prokinetic drugs) while it was successful in 44 patients out of 45 patients among the MC group (the failure was due to intolerable postoperative pain required 2 days admission for parenteral analgesic). Conclusion: MC was a better alternative to LC because of its shorter operative time, lower complication rates and it didn't require learning curve or special instruments. LC had a faster post-operative recovery. | ||||
| Keywords | ||||
| Minilaparotomy; laparoscopic cholecystectomy; one day surgery | ||||
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