Deniz Atasoy, Afag Aghayeva, Turgut Bora Cengiz, Volkan Ozben, Onur Bayraktar, Ismail Hamzaoglu, Tayfun Karahasanoglu, Bilgi Baca. Acibadem Mehmet Ali Aydinlar University, School of Medicine
Intorduction: Laparoscopy is evolving towards less invasiveness. Not only the quality and ergonomics but also the diameter of the instruments is improving. The use of thinner instruments has been hypothesized to reduce pain and increase cosmesis. Since the introduction of mini-laparoscopic cholecystectomy (MLC) in 1997, it gained little interest that could be attributed to decreased durability of the reduced size instruments, poorer optical resolution and smaller jaws of the instrument tips.
Our aim was to compare the outcomes of MLC with traditional laparoscopic cholecystectomy (TLC).
Methods and Procedures : From 6 February 2016 to 26 October 2016 patients who were performed MLC were included to this study. As a comparison group, patients who were performed TLC during the same time period were retrieved. Open and robotic cholecystectomies were excluded. Data were recovered retrospectively from a prospective registry. The variables studied were operation time (OT), blood loss, length of hospital stay (LOS), early (<30 day) complication rate, and postoperative pain (visual analog scale (VAS) score).
MLCs were performed using one 10-mm, one 5-mm, and two 2.4-mm ports (cumulative port size 19.8-mm). TLCs were performed using one 10-mm and three 5-mm ports (cumulative port size 25-mm).
Results: A total of 16 MLC and 75 TLC were performed during the study period. Mean age was 41±12.36 and 46±14.86 for MLC and TLC patients, respectively (p=0.203). Groups were similar regarding gender distribution. The average operating time was 47±15.15 and 70±40.04 min in the MLC and TLC groups, respectively (p=0.021). The average blood loss was 1.88±1.86 and 10±22.19 mL (p=0.005), LOS was 1.19±0.40 and 1.47±1.09 days, and VAS score was 30±19.66 and 32±21.59 in the MLC and TLC groups, respectively. No patients were converted to open. There were two postoperative complications in TLC patients (p=1). One developed choledocholithiasis on postoperative day one and after ERCP the course was uneventful. The other patient developed choledocholithiasis and acute pancreatitis on the sixth postoperative day and was treated conservatively. The stone in the ampulla had fallen by itself without a need for ERCP.
Conclusion: According to the preliminary results of this study, MLC is a safe and feasible technique for the management of laparoscopic cholecystectomy. Further comparative studies are needed before any conclusive statements.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88157
Program Number: P715
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster