An analysis the patients with gallstone were treated with minilaparotomy cholecystectomy in Singburi hospital

Abstract

Background: Laparoscopic cholecystectomy (LC) is the gold standard for the management of symptomatic gallstone and asymptomatic gallstone (with indication for surgery). Minilaparotomy cholecystectomy (MC) (the same minimally invasive surgery as LC) may be a more appropriate option in the resource contained rural setting due to its widespread applicability and comparable outcome with LC

Objective: To study the result of MC on the patients with gallstone and to evaluate the outcome of MC in a rural hospital that  MC may be  alternative  to  LC

Methods: A retrospective chart analysis of 299 patients undergoing Minilaparotomy cholecystectomy by the same surgeon in a rural regional referral hospital in Singburi hospital from  January 2017 toDecember 2021 was undertaken.The data is gathered about;the patient’general features ,operative time,intraoperative blood lost,complication,post operative pain,hospital stay and cost

Results: Of the 299 patients, the majority were female [n = 176, (76.8%)]. The most frequent indicative for MC included: symptomatic gallstone [n = 184, (80.35%)] and asymptomatic gallstone [n = 45, (19.65%)] Four case (1.74%) were converted to open cholecystectomy (OC). The median intraoperative blood lost was 7 ml. (Range 5-215 ml.). The median of postoperative pain 2, 4, 8, 24, 48 hours (numerical rating scale: NRS) = 2 bile leak [n = 2(0.87%)]; bleeding from drain site [n = 1(2.18%)] and wound infection [n = 4(1.78%)]. The median length hospital stay was 5 (range 3-7 day)and median  cost was 12,750 baht

Conclusion: MC is a safe and feasible operation for symptomatic or asymptomatic gallstone when cholecystectomy is indicated. The low operative morbidity and no mortality in the contest of high risk patient profile make this procedure an alternative to LC where LC is inaccessible.