Kirkuk Journal of Science (Jun 2014)
Cholecystectomy: standard, mini, laparoscopic
Abstract
Background: Cholecystitis and gallstone formations are the most common disorders affecting biliary system. Therapeutic removal of gall bladder had evolved from traditional open cholecystectomy to advanced minimally invasive laparoscopic surgery, in addition to mini-cholecystectomy for many purposes, and this study tried to make a comparative study for these three methods of cholecystectomy. Patients and methods: Over two years’ time period, one hundred patient’s already undergone cholecystectomy had been studied. Their cholecystectomy procedure varied according to clinical and scientific bases in to: open, mini and laparoscopic (11, 70, and 19 patients respectively). The morbidity, mortality, length of hospital stay, drain insertion, surgical site infections and time between surgeries to oral intake initiation were questioned. Results: Both Surgical site infection and adynamic ileus were observed in four patients with open surgery (two for each), while none in those undergoing laparoscopic and mini surgery. Postoperatively, time to start oral feeding and withdrawing drain in the standard open surgery were nearly twice in comparison with laparoscopic and mini surgery group. Similarly, time for hospital staying in patients with standard open cholecystectomy was more prolonged than laparoscopic and mini laparotomy method (94 vs. 70 and 60 hours respectively). Only one patient with mini laparotomy needs conversion to classical open cholecystectomy. Conclusions Surgical recovery and hospital staying time were better in the laparoscopic and mini-laparotomy cholecystectomy in comparison with standard open method. However, all general surgeons who operate laparoscopic cholecystectomy must be familiar with mini laparotomy cholecystectomy and open (standard) cholecystectomy in case of an urgent situation.
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