Conference Paper

Laparoscopic Cholecystectomy versus Mini-Laparotomy Cholecystectomy: A randomized controlled trial

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Abstract

Minimally invasive procedures, laparoscopic cholecystectomy (LC) and Mini-Laparotomy ( ML), have largely replaced the traditional cholecystectomy. However, advantages and disadvantages of mini-laparotomy surgery in relation to laparoscopic cholecystectomy are still questionable. Many studies comparing both technique ML, and LC show no differences.in absence of clear evidence indicating which technique is better it was interesting to conduct this study in order to know which technique was better. The aim of our study was to compare the short term outcomes of laparoscopic cholecystectomy (LC) with the minilaprotomy cholecystectomy (ML) for treatment of gallstones. Methods: In this prospective study, patients with gallstones that were referred and enrolled in the study for elective LC or ML between October 2013 and October 2014 at Sohag university hospital, Egypt; Operation, anesthesia, rescue analgeMLs and postoperative care were standardized. The patients were assessed for operation time, postoperative pain, hospital stay and complications in the postoperative period on day 1, 1 week, 1 month and 3 months, postoperatively. Results: Of 220 patients, 110 underwent LC and 110 underwent ML between October 2013 and October 2014 at sohag university hospital sohag in Egypt. In laparoscopic cholecystectomy group (LC) 91OF 110 PATIENTS were female and in mini laprotomy group (ML) 75 of 110 were female (p value.018). The patient's age for LC Group was 37.34±10.88 and for ML group was 32.60±10.55 (p value0.558). As regard operative time the mean operative time for ML group was 42.3182±14.66252 which is significantly lower than LC 52.1364 ± 19.52955(p value0.018). No stastically detected significant different in both group as regard hospital stay, intraoperative, postoperative complication, mortality rate, conversion rate,CBD injury or post-operative pain . Conclusion: The result of ML was comparable to LC but we recommend using ML in in our hospitals as the method of choice for most of the patients due to low cost rate as well as our limited resources. Key words: Gallstone,Laparoscopic cholecystectomy, mini laprotomy cholecystectomy, Complications

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... A vast majority of trials involved one type of surgery vs another type of surgery, with single incision laparoscopic cholecystectomy vs conventional laparoscopic cholecystectomy being the most common trial configuration. Other common configurations were early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy, 72-87 mini laparoscopic cholecystectomy versus laparoscopic cholecystectomy, 88-97 mini laparotomy versus laparoscopic cholecystectomy [98][99][100][101][102][103] and day-case laparoscopic cholecystectomy versus overnight stay laparoscopic cholecystectomy. [104][105][106][107] There were few non-surgical interventions; one study compared shock wave lithotripsy and laparoscopic cholecystectomy, 108 while several compared observation with cholecystectomy. ...
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Background Many completed trials of interventions for uncomplicated gallstone disease are not as helpful as they could be due to lack of standardisation across studies, outcome definition, collection and reporting. This heterogeneity of outcomes across studies hampers useful synthesis of primary studies and ultimately negatively impacts on decision making by all stakeholders. Core outcome sets offer a potential solution to this problem of heterogeneity and concerns over whether the ‘right’ outcomes are being measured. One of the first steps in core outcome set generation is to identify the range of outcomes reported (in the literature or by patients directly) that are considered important. Objectives To develop a systematic map that examines the variation in outcome reporting of interventions for uncomplicated symptomatic gallstone disease, and to identify other outcomes of importance to patients with gallstones not previously measured or reported in interventional studies. Results The literature search identified 794 potentially relevant titles and abstracts of which 137 were deemed eligible for inclusion. A total of 129 randomised controlled trials, 4 gallstone disease specific patient-reported outcome measures (PROMs) and 8 qualitative studies were included. This was supplemented with data from 6 individual interviews, 1 focus group (n=5 participants) and analysis of 20 consultations. A total of 386 individual recorded outcomes were identified across the combined evidence: 330 outcomes (which were reported 1147 times) from trials evaluating interventions, 22 outcomes from PROMs, 17 outcomes from existing qualitative studies and 17 outcomes from primary qualitative research. Areas of overlap between the evidence sources existed but also the primary research contributed new, unreported in this context, outcomes. Conclusions This study took a rigorous approach to catalogue and map the outcomes of importance in gallstone disease to enhance the development of the COS ‘long’ list. A COS for uncomplicated gallstone disease that considers the views of all relevant stakeholders is needed.
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