Randomised Trial of standard Cholecystectomy Versus Mini Cholecystectomy.

Abstract

Gall bladder disease continues to be one of the most common digestive disorder seen by physicians. Removal of the gall bladder is the standard procedure when the gall bladder is diseased or contains calculi. Standard open cholecystectomy has significant morbidity in the form of post operative pain, pulmonary complications, intra abdominal adhesions, infection, incisional hernia and delayed return to work. Improvements in technique enables operation to be performed safely through a smaller incision (5cm), During the 15 month study informed consent to randomization was sought from 60 consecutive patients eligible for the trial. 30 patients had standard and 30 had mini cholecystectomy. Our results show less operating time, less postoperative pain and earlier return to work with mini cholecystectomy than standard cholecystectomy. There were 3 complications in standard cholecystectomy (wound infections-2, biliary leak-1) and 1 in mini cholecystectomy (bile collection- which settled after percutaneous aspiration under ultra sound control). Our results compare favourably with other similar series. In conclusion, cholecystectomy can be safely performed through a 5-7 muscle retracting incision.