[Cholecystectomy using a minilaparotomy].

Recent randomized studies have shown that laparoscopic cholecystectomy has little or even no advantage when compared to minilaparotomy cholecystectomy. The authors report the results of a prospective study of minilaparotomy performed at Dahr el Bacheq governmental hospital where laparoscopic equipment was not available. From July 1994 to July 1997 minilaparotomy cholecystectomy was performed on one hundred consecutive patients (75 women and 25 men with an age varying between 26 and 93 years). However, the cholecystectomy could be accomplished through the mini-incision in only 88 cases. Lengthening of the incision was necessary in 12 cases: common duct stones (8 cases), cancer (2 cases), cholecystoduodenal fistula (2 cases). Intraoperative cholangiography was not performed in 3 cases: very thin cystic duct (2 cases), technical problem (1 case). Two patients operated for acute cholecystitis had wound infection. Postoperative course of the 88 completed minilaparotomy cholecystectomies was uneventful: no mortality, no biliary complications, little pain with low analgesia requirement, oral intake on day 1, discharge from hospital on day 2, return to normal activity between day 8 and day 14. Results of minilaparotomy cholecystectomy compare favorably with those of laparoscopic cholecystectomy. It should be an alternative to laparoscopic cholecystectomy especially when cost is a problem or when laparoscopic equipment is not available and an alternative to conventional open cholecystectomy in the case of contraindication to laparoscopic cholecystectomy.