Minilaparotomy cholecystectomy as a day surgery procedure: a prospective clinical pilot study.
OBJECTIVE
In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure.


METHODS
Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27-68), the mean body mass index 29 kg/m2 (range 19-41). Gallstones were confirmed with ultrasound and the preoperative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter.


RESULTS
The average operating time was 51 minutes (range 30-105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14-30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients.


CONCLUSIONS
The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.
Harju
J
J
Kuusankoski District Hospital, Kuusankoski, Finland. jukka.harju@fimnet.fi
Pääkkönen
M
M
Eskelinen
M
M
D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000379:methods*; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome