Open Minimally Invasive Cholecystectomy in Maharaj Nakhorn Chiang Mai Hospital

Objective The laparoscopic approach is the procedure of choice for cholecystectomy, but the cost of such an operation is very high because it needs expensive, special instruments Laparascopic cholecystectomy (LC) also has a higher risk of biliary injury when compared with conventional open cholecystectomy (COC). Open, minimally invasive cholecystectomy is an alternative procedure that comprises of the benefits of both LC and COC. This study was performed to prove the benefits of open minimally invasive cholecystectomy (OMC). Methods From December 1998 to May 2000, 15 patients were given an OMC in the Department of Surgery, Faculty of Medicine, Chiang Mai University. The incision length, operative time, estimated blood loss, postoperative complications, postoperative pain score, and postoperative hospitalization time were recorded and analysed. Results The OMC was performed successfully in 15 patients. The average operative time was 94 minutes and average estimated blood loss was 35.3 ml. The average length of incision was 30.6 mm. The patients had minimal pain (average pain score 2.7). The postoperative hospitalization time was 59.4 hours and there were no iatrogenic biliary injuries or complications that required a reoperation. Conclusion An OMC might be an alternative choice of treatment in developing and poor countries such as Thailand, because it has had very good results, good cosmetic outcome, short postoperative stay, low postoperative pain score and minimal blood loss. However, we need more sample sizes in the future to conclude these benefits. Chiang Mai Med Bull 2003;42(3):95-103.