A Comparative study of minicholecystectomy versus conventional cholecystectomy.

Thesis Report.

ABSTRACT: Laparoscopic cholecystectomy is being performed in developed countries as an alternative to conventional cholecystectomy for the removal of diseased gallbladder. Minicholecystectomy has become accepted procedure and gained popularity where facility for minicholecystectomy has become an accepted procedure and gained popularity where facility for laparoscopic cholecystectomy does not exist because of the high cost and inavailibity of the equipment, the need for special training to the surgeons etc. This comparative prospective randomized study evaluates the results of two different operative procedures, the conventional cholecystectomy and minicholecystectomy in symptomatic gallstone patients. 64 consecutive patients with symptomatic gallstone disease were prospectively randomized into two groups, minicholecystectomy group (32 patients) and conventional cholecystectomy group (32 patients).The length of incision was 5-7 (mean of 5.56) cm in minicholecystectomy and 10-12 (mean of 10.6) cm in conventional cholecystectomy. These two groups of patients were compared with regard to the following parameters and the results were analysed. a) Operating time: It was 60.96 (50-80) minutes for minicholecystectomy and 59.03 (45-90) minutes for conventional cholecystectomy. There was no significant difference between two procedures (p value>0.05). b) Postoperative analgesic requirement : There was no differnece between two groups for the first 24 hours. but after first post operative day. Conventional cholecystectomy patients required oral analgesic, for longer period with a mean of 4.93 days as compaired to 3.22 days in minicholecystectomy group .The difference was statistically significant ( p value<0.05). c) Oral feeding : Both groups of patients tolerated oral feeding from the first postoperative day and no difference was observed. (p value > 0.05) d) fitness for discharge : When the patients took soft diet and could visit toilet without support of others & there was no need for injectable analgesic , they were deemed fit to be discharged . Minicholesystectomy patients were fit to be discharged on an average of 2.96 days as compared to conventional cholecystectomy patients who were discharged on 3.65(2-6) days. These figures were significantly different (p value < 0.05)