The Clinical Study Of Mini-Laparotomy Cholecystectomy Versus Laparoscopic Cholecystectomy

Objective:To compare the outcomes of mini-laparotomy and laparoscopic surgery for gallstone disease in general surgical practice.Methods:The 160 patients with uncomplicated symptomatic gallstones, conifirmed by ultrasound,were randomly with an random table divided into two groups:74 for MC and for 86 LC.Characteristics of the patients were homogeneous in patients'age,gender,body mass index,American Association of Anesthesiology physical fitness classiication in the two groups.Comparison was made in operating time,postoperative hospitalization days,postoperative course,bleeding loss,incidence of complication and hospital expense.Results:Surgical outcomes:five patients(5.8%) from the laparoscopic group required conversion to open Cholecystectomy,four patients(5.4%) from the Mini-Laparotomy Cholecystectomy group required to extend the incision; Median operating time were 61.5 minutes and 50.2 minutes for LC and MC,respectively,it was significantly shorter for MC(p＜0.05);Median amount of intraoperative bleeding were 35ml in MC group and 30ml in LC group respectively,there was no significant differenc;There were one and zero intraoperative complications in MC group and LC group,respectively,it was no significantly different;There were 17(23%) and 10(12%) analgesic requirements in MC group and LC group,it was significantly different;Time of gastrointestinal function recovery were 36.2 hours and 24.9 hours for MC group and LC group,respectively,it was significantly different;Median postoperative hospital stay were 5.0 days and 4.5 days for MC group and LC group, respectively,it was significantly shorter for LC(p＜0.05);Median sick leave and time for returning to normal everyday activities were similar.Postoperative complications were less frequent in the LC group,but there were no statistical difference in the postoperative complication rate between the two groups.There was no serious bile duct injury in each group.Conclusions:The mini-laparotomy approach has been proven to offer the same benefits as LC,and it costs lower and needs nonspecial equipment setting,so it should be widely used.