Utilizing mini laparoscopy for cholecystectomy on the acute care surgery service

F A Morfesis, MD1, Brian P Rose, MS, MPH1, Dominic L Storto, DO1, Elizabeth Schob, BA2. 1Owen Drive Surgical Clinic of Fayetteville, 2University of North Carolina-Charlotte

Introduction: The use of mini laparoscopic instruments in cholecystectomy has been well described in the prior literature, however the role that it might play in acute care surgery settings remains uncertain. In this small pilot investigation, we examine the efficacy of a hybrid mini laparoscopic approach in patients presenting for management of acute cholecystitis in a community hospital setting.

Methods: Three (3) 3 mm ports were utilized in the right upper quadrant and sub-xyphoid process respectively. A 5 mm camera port was also used. A retrospective analysis was done to examine post-operative outcome measures including pain, infection, narcotic use, length of stay, complication, and hospital readmission.

Results: The average age of the cohort was 52.75 years (27-74) with an average body mass index (BMI) of 27.44(22.70-36.30). Half of the sample (50%) reported having prior, intra-abdominal surgery. There were no post-op infections 0(0%) and only 1(6.25%) ileus. There were 5(31.25%) patients that reported post-op pain requiring hydrocodone or oxycodone greater than 5 post operative days. There was 1(6.25%) readmission and 2(12.50%) complications. There was 1(6.25%) common bile duct leak and 1(6.25%) incisional hernia. The average length of stay in the hospital was 2.19 days (0-6).

Conclusions: The use of the a hybrid technique for mini laparoscopic surgery can be applied in an acute care surgery setting with favorable outcomes. This technique must be further investigated to determine a specific role in the future.

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