Our Summary

The research paper compares two surgical procedures to remove the gallbladder: Laparoscopic cholecystectomy (LC) and minilaparoscopic cholecystectomy (MCL). LC is a popular method because it leads to less pain after surgery, shorter hospital stays, lower costs, and smaller scars. The only downside is that sometimes this method needs to be converted to a traditional open surgery, which happens about 4.8% of the time. However, if the surgeon uses only three incisions instead of four, this conversion rate drops to 3.85%.

The research also looks at MCL, a newer method used in Bangladesh. Even with 7200 patients, only 22 had complications such as hernias or wound infections, and the rate of needing to switch to open surgery was only 0.39%, much lower than LC.

Both methods have similar results in terms of pain after surgery, time spent in the hospital, and recovery time. The main differences are the size of the scar and the likelihood of needing to switch to open surgery. MCL is often preferred by younger patients who care about the size of the scar and want the best results.

FAQs

  1. What is the conversion rate from laparoscopic cholecystectomy to open cholecystectomy?
  2. How does minilaparoscopic cholecystectomy compare to laparoscopic cholecystectomy in terms of conversion rate and complications?
  3. Who is the ideal candidate for minilaparoscopic cholecystectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to follow postoperative care instructions carefully to ensure a smooth recovery. This may include taking prescribed pain medications as directed, avoiding heavy lifting or strenuous activities, and following a diet recommended by the doctor to prevent complications. Additionally, it is important to attend follow-up appointments to monitor healing and address any concerns promptly.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, gallbladder polyps, acute cholecystitis, and biliary colic. Additionally, patients who are at a higher risk for complications from open surgery, such as elderly patients or those with comorbidities, may also be good candidates for laparoscopic cholecystectomy. Patients who prefer a less invasive procedure with faster recovery times and minimal scarring may also be recommended for this procedure.

Timeline

Before laparoscopic cholecystectomy:

  • Patient experiences symptoms of gallbladder issues such as pain in the upper right abdomen, nausea, vomiting, and bloating.
  • Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the presence of gallstones.
  • Surgeon recommends laparoscopic cholecystectomy as the treatment option.

After laparoscopic cholecystectomy:

  • Patient undergoes pre-operative preparation including fasting and medication adjustments.
  • Surgery is performed using small incisions and a laparoscope to remove the gallbladder.
  • Patient typically experiences less postoperative pain, shorter hospital stay, and quicker recovery compared to open cholecystectomy.
  • Patient may experience some discomfort and restricted activity for a few days after surgery.
  • Patient is advised to follow a specific diet and activity restrictions during the recovery period.
  • Patient may have follow-up appointments with the surgeon to monitor the healing process and address any concerns.

What to Ask Your Doctor

  1. What are the advantages of laparoscopic cholecystectomy compared to traditional open cholecystectomy?
  2. What is the typical recovery time after laparoscopic cholecystectomy?
  3. What are the potential risks or complications associated with laparoscopic cholecystectomy?
  4. How often do patients undergoing laparoscopic cholecystectomy require conversion to open cholecystectomy?
  5. Are there any specific factors that may increase my risk of conversion to open cholecystectomy?
  6. How many incisions will be made during the laparoscopic cholecystectomy procedure?
  7. How long will the surgery take, and what type of anesthesia will be used?
  8. What postoperative care instructions should I follow after laparoscopic cholecystectomy?
  9. Will I need to make any lifestyle changes or dietary modifications after the surgery?
  10. Are there any long-term effects or considerations I should be aware of after undergoing laparoscopic cholecystectomy?

Reference

Authors: Romucho Aguilar FB, Zapata Ormeño GC, Alzamora de Los Godos Urcia LÁ, Calderón Saldaña JP, Ausejo Galarza JR. Journal: Rev Esp Enferm Dig. 2023 Sep;115(9):521. doi: 10.17235/reed.2022.9362/2022. PMID: 36454081