title: Open mini-invasive cholecystectomy in high risk elderly. A review of 121 consecutive procedures.
abstract: BACKGROUND
  the report describes the features of a low cost, open mini-invasive procedure for cholecystectomy in a sample of 121 consecutive high risk elderly (ASA score 3 to 5).
  
  
  METHODS
  the surgery is performed through a 3 - 4 cm right subcostal skin incision. An optimal exposition of the operating field was achieved thanks to an innovative three valve retractor.
  
  
  RESULTS
  a mean hospital stay of 3,02 days, low complication rate and 2,4% mortality are the results of the described procedure.
  
  
  CONCLUSIONS
  in high risk elderly the results are extremely encouraging, particularly in comparison with both laparoscopic and traditional open cholecystectomy. The open minisurgical cholecystectomy could be considered a cost-effective alternative to laparoscopy, with excellent results in this subset of patients. The described mini-surgical procedure can also integrate the laparoscopic in case of conversion.
authors.affiliation: University of Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Amato
authors.forename: G
authors.initials: G
authors.lastname: Salamone
authors.forename: G
authors.initials: G
authors.lastname: Romano
authors.forename: A
authors.initials: A
authors.lastname: Agrusa
authors.forename: V
authors.initials: V
authors.lastname: Saladino
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000295:instrumentation* / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007813:Laparotomy / Q000295:instrumentation* / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome