Routine mini-laparoscopic cholecystectomy: Outcome in 200 patients.
BACKGROUND
In order to improve the outcome of classical laparoscopic cholecystectomy (CLC), surgeons have attempted to minimize tissue trauma. The aim of this study is to describe the technique of mini-laparoscopic cholecystectomy (MLC) and to report the outcome of this approach when used as a routine procedure.


METHODS
Since January 2012, all consecutive patients undergoing MLC were included in this study. Operative and perioperative data were prospectively collected. Additionally, cost analysis was performed.


RESULTS
From 2012 to 2015, 200 MLC were performed (F/M: 132/68, mean age 45±16 years). Mean operative duration was 97±32min for the first 50 patients and 75±25min for the subsequent 150 patients (P<0.0001). Modifications in the number or size of trocars were necessary in nine of the first 50 procedures and in seven of the subsequent 150 procedures (P=0.003). Perioperative morbidity included gallbladder perforation (n=28) or moderate (<50mL) bleeding (n=6). Postoperative morbidity was 4%. The mean global cost for a MLC procedure was 1757±1855 euros. This cost decreased from 2946±3115 euros in the first 50 patients to 1390±1278 euros in the subsequent 150 patients (P=0.001).


CONCLUSIONS
Mini-laparoscopy can be used for routine elective cholecystectomy. This approach is associated with low morbidity and good cosmetic results.
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
C
C
Dammaro
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France. Electronic address: hadrien.tranchart@abc.aphp.fr.
H
H
Tranchart
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
M
M
Gaillard
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
A
A
Debelmas
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
S
S
Ferretti
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
P
P
Lainas
AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
I
I
Dagher
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000379:methods*; D002769:Cholelithiasis / Q000191:economics / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005602:France; D017721:Hospital Costs; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome
Cholecystectomy; Laparoscopy; Mini-laparoscopy