Skip to main content
SpringerLink
Log in

Minilaparotomy cholecystectomy versus laparoscopic cholecystectomy

A randomized study with special reference to obesity

  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

Minilaparotomy cholecystectomy (MC) has recently challenged the role of the laparoscopic approach (LC) for cholecystectomies. However, the situation is far from clear when operating times and recovery are evaluated.

Methods

Altogether 157 patients with uncomplicated symptomatic gallstones were randomized into MC (n = 85) and LC (n = 72) groups. Both groups were similar in terms of age, body mass index, American Society of Anesthesiology (ASA) physical fitness classification, and operating surgeon.

Results

The mean operating time was 55 ± 19.5 min in the MC group and 79 ± 27.0 min in the LC group (p < 0.0001). The postoperative hospital stay and length of sick leave did not differ between the two groups. There were no significant differences in postoperative pain, analgesic consumption, or postoperative pulmonary function between the groups. The body mass index did not influence operating time or patient recovery in either group. No major complications occurred in either groups.

Conclusion

The MC procedure seems to be a faster technique than the LC approach for noncomplicated gallstone disease, with no difference in recovery times. The MC procedure also seems to be suitable for the obese patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Al-Tameem MM (1993) Minilaparotomy cholecystectomy. J R Coll Surg Edinb 38: 154–157

    CAS  PubMed  Google Scholar 

  2. Majeed AW, Troy G, Nicholl JP, Smythe A, Reed MW, Stoddard CJ, Peacock J, Johnson AG (1996) Randomised, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. Lancet 347: 989–9940

    Article  CAS  PubMed  Google Scholar 

  3. Makinen AM, Nordback IH (1995) Cholecystectomy: comparison of minilaparotomy and laparoscopy. Int Surg 80: 99–101

    CAS  PubMed  Google Scholar 

  4. McGinn FP, Miles AJ, Uglow M, Ozmen M, Terzi C, Humby M (1995) Randomized trial of laparoscopic and minicholecystectomy. Br J Surg 82: 1374–1377

    CAS  PubMed  Google Scholar 

  5. McMahon AJ, Russell IT, Baxter JN, Ross S, Anderson JR, Morran CG, Sunderland G, Galloway D, Ramsay G, O´Dwyer PJ (1994) Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial. Lancet 343: 135–138

    Article  CAS  PubMed  Google Scholar 

  6. McMahon AJ, Russell IT, Ramsay G, Sunderland G, Baxter JN, Anderson JR, Galloway D, O´Dwyer PJ (1994) Laparoscopic and minilaparotomy cholecystectomy: a randomized trial comparing postoperative pain and pulmonary function. Surgery 115: 533–539

    CAS  PubMed  Google Scholar 

  7. Miles RH, Carballo RE, Prinz RA (1992) Laparoscopy: the preferred method of cholecystectomy in the morbidly obese. Surgery 818–822

  8. Oyogoa SO, Komenaka IK, Ilkhani R, Wise L (2003) Minilaparotomy cholecystectomy in the era of laparoscopic cholecystectomy: a community-based hospital perspective. Am Surg 69: 604–607

    PubMed  Google Scholar 

  9. Ros A, Gustafsson L, Krook H, Nordgren CE, Thorell A, Wallin G, Nilsson E (2001) Laparoscopic cholecystectomy versus minilaparotomy cholecystectomy: a prospective, randomized, single-blind study. Ann Surg 234: 741–749

    Article  CAS  PubMed  Google Scholar 

  10. Schirmer BD, Dix J, Edge SB, Hyser MJ, Hanks JB, Aguilar M (1992) Laparoscopic cholecystectomy in the obese patient. Ann Surg 216: 146–152

    CAS  PubMed  Google Scholar 

  11. Schmitz R, Rohde V, Treckmann J, Shah S (1997) Randomized clinical trial of conventional cholecystectomy versus minicholecystectomy. Br J Surg 84: 1683–1686

    Article  CAS  PubMed  Google Scholar 

  12. Squirrell DM, Majeed AW, Troy G, Peacock JE, Nicholl JP, Johnson AG (1998) A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 123: 485–495

    Article  CAS  PubMed  Google Scholar 

  13. Srivastava A, Srinivas G, Misra MC, Pandav CS, Seenu V, Goyal A (2001) Cost-effectiveness analysis of laparoscopic versus minilaparotomy cholecystectomy for gallstone disease. a randomized trial. Int J Technol Assess Health Care 17: 497–502

    CAS  PubMed  Google Scholar 

  14. Syrakos T, Antonitsis P, Zacharakis E, Takis A, Manousari A, Bakogiannis K, Efthimiopoulos G, Achoulias I, Trikopupi A, Kiskinis D (2004) Small-incision (minilaparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital. Langenbecks Arch Surg 389: 172–177

    Article  PubMed  Google Scholar 

  15. Tyagi NS, Meredith MC, Lumb JC, Caccad RG, Vanterpool CC, Rayls KR, Zerega WD, Silbergleit A (1994) A new minimal invasive technique for cholecystectomy: subxiphoid “minimal stress triangle” microceliotomy. Ann Surg 220: 617–625

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Drs. Heikki Hendolin, MD, and Markku Ruoppi, MD, Department of Anaesthesiology, and our colleagues at the Department of Surgery, Kuopio University Hospital for data collection. This study was supported by EVO-funds from Kuopio University Hospital.

Author information

Authors and Affiliations

  1. Department of Surgery, Kuopio University Hospital, Post Office Box 1777, Kuopio, 70211, Finland

    J. Harju, P. Juvonen, M. Eskelinen, P. Miettinen & M. Pääkkönen

Authors
  1. J. Harju
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Juvonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Eskelinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Miettinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Pääkkönen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Harju.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harju, J., Juvonen, P., Eskelinen, M. et al. Minilaparotomy cholecystectomy versus laparoscopic cholecystectomy. Surg Endosc 20, 583–586 (2006). https://doi.org/10.1007/s00464-004-2280-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-004-2280-6

Keywords

Search

Navigation