Mini-cholecystectomy under local anaesthesia

Abstract

OBJECTIVE: Reports of mini-cholecystectomy (MC) under general anaesthesia in the surgical treatment of gallbladder disease are common, but those of MC under local anaesthesia are much more limited. We report our experience of MC under local anaesthesia. METHODS: Forty-two patients with gallstone disease scheduled for MC under local anaesthesia were included in this study. Twenty-seven were female, with a median age of 54.5 years (range, 29-71) and median body mass index (BMI) of 20.5 (range, 17.6-23.4). None of the patients had evidence of acute cholecystitis on admission or previous upper abdominal surgery. MC was performed by a standardized technique and under the combination of local anaesthesia (1% Xylocaine with adrenaline) and intravenous administrations of fentanyl (0.001-0.002 mg/kg) and midazolam (0.05-0.1 mg/kg). RESULTS: The median operative time was 40 minutes (range, 35-64). Local anaesthesia was converted to general anaesthesia in two patients owing to the discomfort caused by lysis of dense adhesions around the gallbladder, giving a success rate of 95%. MC was done successfully in all patients without any postoperative complications. The median hospital stay was 5 days (range, 2-7). CONCLUSION: MC under local anaesthesia is an effective surgical procedure for patients with BMI of less than 24, who have no evidence of acute inflammation of the gallbladder and no previous upper abdominal surgery. © 2007 Elsevier. All rights reserved.