title: Advantages of mini-laparotomy approach in treatment of acute destructive cholecystitis.
abstract: The aim of the present work is to reveal the advantages of laparotomic cholecystectomy by mini access. 1152 patients with cholelithiasis from 17 to 83 years old were operated during 2001 - 2007 (913 - female; 239 male). 85 were more than 70 years old; average duration of operation was 30 - 40 min. Of 1152 operations - 319 operations were performed for destructive forms of acute cholecystitis. There were 225 cases of phlegmonous forms. 94 operations were performed because of gangrenous form. Once we widened the mini-incision to 10 sm. There was 1 case of lethality. We didn't meet serious complications in the other cases. The number of average bed - days was 1-2. Patients return to usual social and working activity in a short time. Thus, mini-laparotomic technology is a convenient and quite universal and, what is the most important, a reliable method of treatment of cholelithiasis and destructive forms of acute cholecystitis. With introduction of mini-laparotomic technologies the expenses for treating are reduced. It allows to get good results of treatment. According to our estimation and literary data MC's economic effects are 8-10 times more as compared to LC's and 5 times more than of a TC's. This is the operation of choice in treatment of acute destructive cholecystitis with good postoperative and remote results. Given method has many advantages and deserves application even in the situation when LC is contraindicated, that allows to save the mini-invasion as an idea.
authors.affiliation: Research Institute of Medical Radiology, Georgian AS, Tbilisi Clinical Hospital N4.
authors.forename: Z
authors.initials: Z
authors.lastname: Beriashvili
authors.forename: M
authors.initials: M
authors.lastname: Gurgenidze
authors.forename: M
authors.initials: M
authors.lastname: Zurashvili
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D013997:Time Factors