Minilaparotomy in the Surgical Management of Gallstone Disease: A Practical and Effective Approach

Abstract

Objectives: This study aimed to enhance the outcomes of surgical treatment for patients with gallstone disease by utilizing a minilaparotomy approach.

Methods: A prospective clinical analysis was conducted involving 259 patients diagnosed with acute or chronic calculous cholecystitis. All patients were treated in the Department of Abdominal Surgery at the Khorezm Regional Multidisciplinary Medical Center, affiliated with the Department of General Surgery at the Urgench branch of the Tashkent Medical Academy. Preoperative assessments included standard laboratory tests (complete blood count, urinalysis, biochemical profile, coagulation tests, serologic screening for RW, HBsAg, and HBVg), electrocardiography, chest radiography, abdominal and pelvic ultrasound, and upper gastrointestinal endoscopy to identify coexisting conditions and assess the major duodenal papilla.

Results: Cholecystectomy was performed through a minilaparotomy approach, using either a right-sided transrectal or pararectal incision. Both techniques involved partial disruption of motor and sensory nerve fibers of the right abdominal wall, which manifested postoperatively as restricted movement and increased pain levels. However, the use of a small oblique Kocher-type incision in the right hypochondrium, avoiding muscle and nerve injury, significantly reduced these adverse effects.

Conclusion: A minimally invasive Kocher incision for cholecystectomy offers a safer alternative by preserving muscular and neural structures, thereby reducing postoperative pain and complications. This approach appears to improve patient recovery and surgical outcomes in the management of gallstone disease.