Revisiting Mini-Cholecystectomy in Laparoscopic Era – A Retrospective Study

BACKGROUND Mini-cholecystectomy (MC), with its varied incision length, has long been considered feasible with comparable results to laparoscopic cholecystectomy (LC) 1-6,7 We undertook this study, driven by resource-constraints, by well-experienced surgeons, using 3 - 5 cm incision length, in our patients with low BMI. The aim of this study is to compare the results and outcomes between MC and LC. METHODS In this retrospective study of a prospectively maintained database, first 50 patients each were selected for MC and LC respectively. Operative time, pain-score, SSI (Surgical Site Infection), hospital stay, return to normal activity and complications were compared. RESULTS Both groups were matched for age, sex, BMI (Body Mass Index) and American Society of Anesthesiologists (ASA) grading. The mean operating time for MC was 43 minutes and for LC, 64 minutes. Hospital stay for MC was 1.9 days and for LC was 1.8 days, which was statistically not significant. Return to normal activity was 8 days for MC and 6.6 days for LC. In a subset analysis of eight lean and thin patients using 3 - 3.5 cm length incision with rectus muscle splitting, the return to normal activity was 6.9 days which is comparable to LC patients. CONCLUSIONS Mini-cholecystectomy and laparoscopic cholecystectomy produce comparable patient outcomes. In lean and thin patient, MC may be slightly more advantageous than LC in terms of less operating time. KEYWORDS Mini-Cholecystectomy, Laparoscopic Cholecystectomy, Outcome, Lean and Thin Patient