Abstract
Background:
The safety and feasibility of minilaparoscopic cholecystectomy has not been documented with a large patient sample. This study reports the results of 1,011 minilaparoscopic cholecystectomies performed in a single institution.
Methods:
From November 1997 to May 2002, 1,023 consecutive patients underwent minilaparoscopic cholecystectomy at National Taiwan University Hospital, Taipei, Taiwan. Patients with clinical evidence of common bile duct stones (1 patient) and combined surgery for other purposes (11 patients) were excluded. The operative indication, total operative time, conversion rate, hospital stay, morbidity and mortality of 1,011 patients were reviewed and statistically analyzed.
Results:
Minilaparoscopic cholecystectomy was performed in 1,009 of 1,011 patients (375 males and 636 female; mean age, 54.8 years; range 13–92 years). The total operative time was 68.8 ± 31.9 min. The total hospital stay was 2.5 ± 2 days. One patient (0.10%) underwent conversion to open cholecystectomy because of common hepatic duct laceration. One patient (0.10%) underwent conversion to standard laparoscopic cholecystectomy for control of cystic artery bleeding. Ten patients (0.99%) experienced major complications including intraabdominal abscess (1 patient), bile leakage (5 patients), major bile duct injury (2 patients), bowel injury (1 patient), and postoperative hemorrhage (1 patient). Eleven patients (1.09%) had minor complications including wound infection, incisional herniation, postoperative ileus, and acute urine retention. One patient (0.10%) with bleeding tendency succumbed to postoperative hemorrhage.
Conclusions:
Minilaparoscopic cholecystectomy is a technically demanding approach. Our results indicate that this procedure could be performed successfully and safely by experienced surgical teams.
Similar content being viewed by others
References
A Alponat CK Kum BC Koh A Rajnakova P Goh (1997) ArticleTitlePredictive factors for conversion of laparoscopic cholecystectomy World J Surg 21 629–633 Occurrence Handle1:STN:280:ByiA2svitFU%3D Occurrence Handle9230661
WK Cheah JE Lenzi JB So CK Kum PM Goh (2001) ArticleTitleRandomized trial of needlescopic versus laparoscopic cholecystectomy Br J Surg 88 45–47 Occurrence Handle10.1046/j.1365-2168.2001.01636.x Occurrence Handle1:STN:280:DC%2BD3M7isFGnsA%3D%3D Occurrence Handle11136308
D Davides SP Dexter A Vezakis M Larvin P Moran MJ McMahon (1999) ArticleTitleMicropuncture laparoscopic cholecystectomy Surg Endosc 13 236–238 Occurrence Handle10.1007/s004649900953 Occurrence Handle1:STN:280:DyaK1M7msF2jsw%3D%3D Occurrence Handle10064754
A Faggioni G Moretti A Mandrini P Viazzi A Noceti M Faggioni (1998) ArticleTitleMinilaparoscopic cholecystectomy Hepatogastroenterology 45 1014–1017 Occurrence Handle1:STN:280:DyaK1cvislCgsg%3D%3D Occurrence Handle9755999
DR Flum C Flowers DL Veenstra (2003) ArticleTitleA cost-effectiveness analysis of intraoperative cholangiography in the prevention of bile duct injury during laparoscopic cholecystectomy J Am Coll Surg 196 385–393 Occurrence Handle10.1016/S1072-7515(02)01806-9 Occurrence Handle12648690
CH Hsieh (2003) ArticleTitleEarly minilaparoscopic cholecystectomy in patients with acute cholecystitis Am J Surg 185 344–348 Occurrence Handle10.1016/S0002-9610(02)01417-4 Occurrence Handle12657387
NA Kama M Doganay M Dolapci E Reis M Atli M Kologlu (2001) ArticleTitleRisk factors resulting in conversion of laparoscopic cholecystectomy to open surgery Surg Endosc 15 965–968 Occurrence Handle10.1007/s00464-001-0008-4 Occurrence Handle1:STN:280:DC%2BD3MrlvVCkuw%3D%3D Occurrence Handle11443475
GM Larson GC Vitale J Casey JS Evans G Gilliam L Heuser G McGee M Rao MJ Schem CR Voyles (1991) ArticleTitleMultipractice analysis of laparoscopic cholecystectomy in 1,983 patients Am J Surg 1 2–7
PL Leggett CD Bissell R Churchman-Winn (2001) ArticleTitleCosmetic minilaparoscopic cholecystectomy Surg Endosc 15 1229–1231 Occurrence Handle10.1007/s004640041018 Occurrence Handle1:STN:280:DC%2BD3MnotV2ntA%3D%3D Occurrence Handle11727116
DEM Litwin MJ Girotti EC Poulin J Mamazza AG Nagy (1992) ArticleTitleLaparoscopic cholecystectomy: trans-Canada experience with 2,201 cases Can J Surg 35 291–296 Occurrence Handle1:STN:280:By2A3MrgvVM%3D Occurrence Handle1535548
BV MacFadyen SuffixJr R Vecchio AE Ricardo CR Mathis (1998) ArticleTitleBile duct injury after laparoscopic cholecystectomy. The United States experience Surg Endosc 15 315–321
SN Mehta E Pavone JS Barkun GA Cortas AN Barkun (1997) ArticleTitleA review of the management of postcholecystectomy biliary leaks during the laparoscopic era Am J Gastroenterol 92 1262–1267 Occurrence Handle1:STN:280:ByiH3crnsVY%3D Occurrence Handle9260786
MJ Moore CL Bennett (1995) ArticleTitleThe learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club Am J Surg 170 55–59 Occurrence Handle10.1016/S0002-9610(99)80252-9 Occurrence Handle1:STN:280:ByqA3MzotVc%3D Occurrence Handle7793496
SS Ngoi P Goh K Kok CK Kum WK Cheah (1999) ArticleTitleNeedlescopic or minisite cholecystectomy Surg Endosc 13 303–305 Occurrence Handle10.1007/s004649900971 Occurrence Handle1:STN:280:DyaK1M7msF2iuw%3D%3D Occurrence Handle10064772
J Perissat (1993) ArticleTitleLaparoscopic cholecystectomy: the European experience Am J Surg 165 444–449 Occurrence Handle1:STN:280:ByyB2czlt1A%3D Occurrence Handle8480879
PR Reardon JI Kamelgard B Applebaum L Rossman FC Brunicardi (1999) ArticleTitleFeasibility of laparoscopic cholecystectomy with miniaturized instrumentation in 50 consecutive cases World J Surg 23 128–131 Occurrence Handle1:STN:280:DyaK1M%2FpslWnsw%3D%3D Occurrence Handle9880420
F Risquez Q Pennehouat R Fernandez E Confino O Rodriguez (1993) ArticleTitleMicrolaparoscopy: a preliminary report Hum Reprod 8 1701–1702 Occurrence Handle1:STN:280:ByuC3s3ivVE%3D Occurrence Handle8300832
L Sarli R Costi G Sansebastiano (2001) ArticleTitleMinilaparoscopic cholecystectomy vs laparoscopic cholecystectomy Surg Endosc 15 614–618 Occurrence Handle10.1007/s004640000316 Occurrence Handle1:STN:280:DC%2BD3MrksV2msA%3D%3D Occurrence Handle11591952
R Thomas (1993) ArticleTitleU.S. experience with laparoscopic cholecystectomy Am J Surg 165 450–454 Occurrence Handle8480880
SC Yu RH Yuan SC Chen WJ Lee (1999) ArticleTitleCombined use of minilaparoscope and conventional laparoscope in laparoscopic cholecystectomy: preservation of minimal invasiveness J Laparoendosc Adv Surg Tech 9 57–62 Occurrence Handle1:STN:280:DyaK1M3htVGqug%3D%3D
RH Yuan WJ Lee SC Yu (1997) ArticleTitleMinilaparoscopic cholecystectomy: a cosmetically better, almost scarless procedure J Laparoendosc Adv Surg Tech 7 205–211 Occurrence Handle1:STN:280:DyaK1c7gslyjsQ%3D%3D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lee, PC., Lai, IR. & Yu, SC. Minilaparoscopic (needlescopic) cholecystectomy: a study of 1,011 cases. Surg Endosc 18, 1480–1484 (2004). https://doi.org/10.1007/s00464-003-8247-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-8247-1