72297 - Cholecystectomy through minilaparotomy

Introduction The gold standard for managing gallstone disease is nowadays laparoscopic cholecystectomy. Nevertheless, few studies have evaluated the long-term outcomes of cholecystectomy by mini-laparotomy. The aim of this study was to evaluate complications following cholecystectomy through mini-laparotomy. Method The study population consisted of patients undergoing cholecystectomy by mini-laparotomy 2007-2012 in Motala registered in GallRiks. Patients with registered complications were matched with a control group in a 1:2 ratio based on gender and age. Data were retrieved from GallRiks and a retrospective patient report review assembling variables related to complications, patient satisfaction and health status. A chi-2 test analyzed risk factors and co-morbidities; other results were presented descriptively. Result During the study period, 599 patients underwent cholecystectomy. Thirty-three patients (5.5%) were registered in GallRiks as suffering a complication, including 29 (4.8%) surgical complications. Registered complications were infection (n=12), bleeding (n=8), liver lesion (n=2), bile duct injury (n=2), leakage from cystic duct (n=2), bile duct stones (n=1), ileus (n=1) and gastritis (n=1). Risk factors such as smoking, transection of rectus muscle or incision size showed no significant correlation to complication incidence. The co-morbidities diabetes, pulmonary disease and coronary heart disease had no significant impact on outcomes regarding complications. Discussion The results of this study may suggest that mini-laparotomy could be a safe option for cholecystectomy when the first-hand method, laparoscopy, is unavailable or inappropriate.