Abstract
We report our experience of laparoscopic cholecystectomy using needlescopic instruments for acute or chronic cholecystitis after resolution of acute inflammation. During recent five years, eleven needlescopic cholecystectomies were performed in eight males and three females. Their mean age was 57 years. Percutaneous gallbladder drainage was preoperatively performed in two patients. The mean duration from onset to operation was 25 days. Under general anesthesia, 12-mm port was placed at the subumbilicus, and three 2-mm or 3-mm needlescopic ports were inserted at right upper quadrant under the guidance of laparoscope. There were no conversions to open surgery. Needlescopic instruments were converted to conventional ones due to the difficulty of manipulation of gallbladder in two patients. The mean operation time was 154 min. There were no severe intra-and postoperative complications, however, we experienced an postoperative intra-abdominal abscess requiring percutaneous drainage in one patient. The mean postoperative hospital stay was 10 days. Although laparoscopic cholecystectomy using needlescopic instruments for acute or chronic cholecystitis is feasible with the strict evaluation of the patients and the adequate control of associated diseases preoperatively, we require a careful surgical technique with the consideration of morbidity.
