Mini-cholecystectomy: experience of 324 cases

ABSTRACT

To determine the frequency of patients with symptomatic gallstones in whom a cholecystectomy could safely be accomplished through a 5 cm or less "mini-lap" incision. This is a retrospective study of 324 consecutive cases of symptomatic gallstones that underwent cholecystectomy through a 5cm or less transverse sub-costal incision, from June 1996 to June 2001, a total period of five years. The study was conducted at the surgical department of Khyber Teaching Hospital, Peshawar. A "mini-lap" cholecystectomy was possible through a 5cm or less incision in 289 [89%] cases, compared to 35 [11%] cases, where the incision required extension beyond 5 cm. The total morbidity recorded was 8.7%. The incidence of bile duct injury was 0.3%, because of a single patient who developed a post-operative bile duct stricture necessitating a re-laparotomy and a hepatico-jejunostomy. There was a single postoperative death recorded, giving a mortality of 0.3%. The study clearly confirmed that a "mini-lap" cholecystectomy, which boasts many advantages over conventional open cholecystectomy, is a safe and viable alternative to laparoscopic cholecystectomy and can be performed in the vast majority of patients with symptomatic gallstones