Gómez CLR, Ramírez OBC, Ovando JE, Aguilar SJ, Aznar AJC, Pazarán MCD

Language: Spanish
References: 19
Page: 158-162
PDF size: 37.95 Kb.

ABSTRACT

Objective: To compare the response to pain in patients subjected to cholecystectomy according to the extension of the minilaparotomy.
Setting: Second level health care hospital.
Design: Prospective, longitudinal, observational study.
Method: We studied 139 patients subjected to cholecystectomy through subcostal minilaparotomy from November 1994 to November 1999. Four groups were assigned according to the size of the incision. Group I, smaller than 4 cm (11 patients); Group II, from 4.1 to 6 cm (45 patients); Group III, from 6 to 8 cm (51 patients); Group IV, from 8.1 to 10 cm (32 patients). Response to pain was determined through a visual analogue scale at the immediate postoperative period, 24 h after surgery, and at the time of hospital discharge. We studied the following variables: age, gender, preoperative diagnosis, concomitant diseases, trans- and post-operative complication, respiratory restriction, days of hospital stay, and mortality.
Results: Average age was 37.6 years, 114 patients were women and 25 were men; 133 patients had a diagnosis of chronic lithiasic cholecystitis, 6 were alithiasic, 10 were in acute stage. The main biliary tract was explored in 6 patients due to choledocholithiasis. Incisions smaller than 4 cm produced low intensity and short-lasted pain, no differences were found between groups II and III. Hospital stay averaged 2.6 days, seven (5%) patients presented complications: three with biliary effusion through the Penrose, two with wound infection, one patient formed a seroma, and one developed severe headache. No respiratory restriction was induced and no deaths occurred.
Conclusion: Cholecystectomy through reduced invasion is an alternative for the surgeon; patients refer minimal to moderate pain; it does not induce respiratory restriction and can be performed at any second level health care hospital.

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