Mini laparoscopic cholecystectomy: a better outcome

ABSTRACT

The outcomes after traditional laparoscopic cholecystectomy [LC; one 10 mm port, one 12 mm port and two 5 mm ports] and mini laparoscopic cholecystectomy [MLC; three 3mm ports and one 12mm port] for gall stone disease were compared. The study was a randomized, single blind trial comparing LC with MLC. The randomization period was from February 2003 to December 2004. Two groups of patients underwent the surgery, 48 underwent LC and 47 underwent MLC. Patients were randomized by means of a blind envelop system just before surgery. The groups were matched for age, sex and preoperative characteristics. Median [range] operating times for LC and MLC were similar 45 [20- 120] and 50[20-170] mm. respectively. Intraoperative and postoperative complication rates, the time for the patient to resume walking, eating and passing stools, and median hospital stay were the same in the two groups. The level of post operative pain was lower in the MLC group at 1 h, 3h, 6h, 12h and 24h. Patients who had MLC received fewer injections of analgesic [p=0.036] and more patients in this group expressed satisfaction with the cosmetic result [p= 0.001]. MLC took a similar time to perform and caused less postoperative pain than the standard laparoscopic procedure. Reducing the port size further enhanced the advantages of laparoscopic over open cholecystectomy