Needlescopic versus laparoscopic cholecystectomy. A prospective study of 60 patients.
OBJECTIVE
To test the hypothesis that needlescopic cholecystectomies (NC) offer superior outcomes in comparison to common laparoscopic cholecystectomies (LC).


METHODS
Sixty consecutive patients with gallbladder disease undergoing either LC or NC were evaluated with respect to differences in operative time, frequency of per-operative incidents, post-operative pain, late postoperative symptoms, length of scars and level of postoperative satisfaction.


RESULTS
Mean operative time was similar in both groups. Most of the patients, irrespective of the technique, informed mild postoperative pain. NC patients had lower levels of pain on the 7th postoperative day (PO7) (p<0.01) and decreased need for additional analgesia. Less frequency of epigastric wound pain was observed in NC patients until PO4 (p<0.01). Aesthetic result was far superior after NC (total length of scars less than half after LC). No differences regarding postoperative satisfaction with the operation were observed between the studied groups.


CONCLUSIONS
Both techniques were safe and effective, presenting similar operative times and low levels of postoperative pain. Downsizing the ports to 2-3 mm was associated with significantly less frequency of postoperative pain only in the epigastric wound until PO4. Aesthetic outcome of NC was significantly superior to LC, although this advantage did not influence patient level of satisfaction.
Cabral
Pedro Henrique Oliveira
PH
Santa Casa de São Paulo, Medical Sciences Faculty, Brazil.
Silva
Ivan Tramujas da Costa e
IT
Melo
Janaína Vieira
JV
Gimenez
Felicidad Santos
FS
Cabral
Celso Rômulo Barbosa
CR
Lima
Ana Paula Calheiros de
AP
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002764:Cholecystitis / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009339:Needles; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome