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Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital

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Abstract

Background and aims

Since the introduction of laparoscopic cholecystectomy into general practice in 1990, it has rapidly become the dominant procedure for gallbladder surgery. The aim of this study was to compare the results of the laparoscopic, open and mini-laparotomy approaches to cholecystectomy.

Patients and methods

Our study covers a period of 6 years. A total of 1,276 patients underwent cholecystectomy for calculous biliary disease. The laparoscopic procedure was applied to 952 (74.6%) patients, while 210 (16.5%) underwent the traditional open cholecystectomy and the remaining 114 (8.9%) patients underwent mini-laparotomy cholecystectomy.

Results

Thirty-seven patients (3.9%) from the laparoscopic group required conversion to open cholecystectomy. Morbidity was similar in the open and laparoscopic groups (3.8%), while it was significantly lower in the mini-laparotomy group (0.8%). No major bile duct injuries occurred after the open or mini-laparotomy approaches. The median operation time was significantly shorter in the mini-laparotomy group than in the laparoscopic group (46 min vs 61 min). Hospital stay was significantly longer for the open cholecystectomy group (mean value 5.1 days) compared with the laparoscopic and mini-laparotomy groups (mean values 2.5 days and 2.7 days, respectively). Hospital expenses showed a saving of 786€ for each patient who underwent the open procedure and 980€ for each patient who underwent the mini-laparotomy approach compared with the laparoscopic one.

Conclusion

We believe that commissioners of healthcare should question whether the benefits of laparoscopic cholecystectomy justify the additional cost after the introduction of the mini-laparotomy approach.

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Authors and Affiliations

  1. A’ Surgical Clinic, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Theodoros Syrakos, Polichronis Antonitsis, Konstantinos Bakogiannis, George Efthimiopoulos, Ignatios Achoulias & Dimitrios Kiskinis

  2. A’ Surgical Clinic, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Peripheral Road N. Efkarpia, 564 03, Thessaloniki, Greece

    Theodoros Syrakos

  3. Surgical Department, District Hospital of Veroia, Veroia, Greece

    Emmanouil Zacharakis, Athanasios Takis & Antonia Manousari

  4. Anesthesiology Department, AHEPA University Hospital, Thessaloniki, Greece

    Anastasia Trikoupi

Authors
  1. Theodoros Syrakos
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  2. Polichronis Antonitsis
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  3. Emmanouil Zacharakis
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  4. Athanasios Takis
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  5. Antonia Manousari
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  6. Konstantinos Bakogiannis
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  7. George Efthimiopoulos
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  8. Ignatios Achoulias
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  9. Anastasia Trikoupi
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  10. Dimitrios Kiskinis
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Correspondence to Theodoros Syrakos.

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Syrakos, T., Antonitsis, P., Zacharakis, E. et al. Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbecks Arch Surg 389, 172–177 (2004). https://doi.org/10.1007/s00423-004-0481-z

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  • DOI: https://doi.org/10.1007/s00423-004-0481-z

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