Minilaparotomy cholecystectomy – An appropriate alternative to laparoscopic cholecystectomy in developing nations.

ABSTRACT

Background: This study reports the experience of performing minilaparotomy cholecystectomy (MC) and assesses the peri-operative outcome of this surgery in the setting of a developing country. Methods: Data of all patients who underwent minilaparotomy cholecystectomy by a single surgical unit were collected and reviewed. These included demographics, surgical technique used, peri-operative complications and length of hospital stay. Descriptive analyses were done. Results: 476 patients who underwent elective minilaparotomy cholecystectomy in a single surgical unit over a 15 year period were studied. Of these, 84.8% were female. The mean age was 47 years. The most common indication for surgery was symptomatic cholelithiasis with chronic cholecystitis (66%). Mean length of the surgical incision was 4.8 cm and mean operating time was 31 min. Rate of conversion to conventional open cholecystectomy was 4%. Median hospital length of stay was 22 hours. Minor wound infection was the only surgical post-operative complication recorded in 7 patients. Nine patients in the converted group and 3 in the minilaparotomy cholecystectomy group had significant vomiting. There was no mortality. Conclusion: The study reinforces the view that minilaparotomy cholecystectomy can be safely and effectively performed with minimal peri-operative complications, and is ideal for developing country settings.