Background: Surgical technique using small-diameter instruments and single-INCISION laparoscopy are two new options for less invasive LAPAROSCOPIC CHOLECYSTECTOMY (LC). In this study, we have compared mini-LC (MLC) with single-INCISION LC (SILC). Materials and Methods: This study is a randomized clinical trial conducted on the patients diagnosed with symptomatic cholelithiasis who underwent LC. Forty patients were randomized to two equal groups of MLC and SILC. They were compared in terms of demographic data, operation time, and surgical complications.Results: Baseline characteristics were similar in two groups. Operation time in MLC was significantly shorter than that in SILC (45.1 ± 69 min vs 63.75 ± 7.57 min, P-value<0.001). Also, the total length of the wound in SILC group was shorter than that in MLC group (P-value<0.003). Postoperative pain scores were similar in two groups. Hospital stay was shorter in MLC (1.2 ± 0.6 days vs 1.6 ± 0.8 days, P<0.021). There was no difference in postoperative complications in two groups.Conclusion: MLC because of less operation time is preferred than SILC. Also, by subjective measures, it was a more comfortable method compared to SILC.

Introduction & Objective: The first documented LAPAROSCOPIC CHOLECYSTECTOMY was performed by Erich Mühe in Germany in 1985. In the developed countries, currently over 90% of cholecystectomies are performed LAPAROSCOPICally. It is generally believed that LAPAROSCOPIC CHOLECYSTECTOMY has better results than open CHOLECYSTECTOMY in term of patient's compliance and early return to work but it seems that the final outcomes are not different. New studies show that open cholecystectomies with small INCISION are a good alternative for the selected patients. The aim of this study was to compare the efficacy of LAPAROSCOPIC and open CHOLECYSTECTOMY in the clinical outcome and patient satisfaction.Materials & Methods: Between January 2005 and August 2006, 150 patients with a diagnosis of symptomatic gallstone, were assigned for CHOLECYSTECTOMY. They were divided in two groups; the first group (n=91) were assigned to open CHOLECYSTECTOMY in Baqiyatallah hospital; the second group (n=59) were assigned to LAPAROSCOPIC CHOLECYSTECTOMY in Milad hospital. Then they followed for their symptoms of recovery and satisfaction four month later.Results: After four months follow up there was no differences observed in symptoms of recovery and patient satisfaction (62.6% vs. 62.7) between the two groups. The improvement rate of abdominal pain after LAPAROSCOPIC and open CHOLECYSTECTOMY seems to be very good and equivalent for 63% of the patients in the two groups, although improvement of symptoms in dyspeptic patients were lower, but it was similar within the both groups.Conclusions: LAPAROSCOPIC surgeries are more expensive because of its modern equipments and expensive Instruments. Open CHOLECYSTECTOMY, especially with small INCISION, is an acceptable alternative for the treatment of symptomatic gallstone disease. It is recommended to have the open cholecystectomies with small INCISIONs for the patients who don’t need to return to work early or for the patients who cannot offer for LAPAROSCOPIC CHOLECYSTECTOMY.

BACKGROUND AND OBJECTIVE: LAPAROSCOPIC CHOLECYSTECTOMY (LC) is now used in the management of acute cholecystitis. The aim of this study was to evaluate the role of LC for acute cholecystitis (AC) and compare it with acute open CHOLECYSTECTOMY (OC) and elective LAPAROSCOPIC CHOLECYSTECTOMY (ELC) in terms of complications, conversion rate, and hospital stay and operation time.METHODS: This clinical study was carried out 01) 235 patients. Ninety-four patients with AC were admitted to emergency department. They were randomly divided into acute LAPAROSCOPIC CHOLECYSTECTOMY (ALC) (n=46) and OC(n=48). One hundred and forty one patients with symptomatic gallstone underwent ELC.FINDINGS: The median of total stay was 5, 3 and 2 days (mean±SD 5.39±2.9, 3.39±3.14 and 1.99±1.3 days) in OC, ALC and ELC, respectively (p=0.005). The mean duration of operation time was 53.2±3.2, 58.8±29.3 and 39.9±18.8 minutes in OC, ALC and ELC, respectively (p=0.005). Major complications occurred in 5 patients (10.4%) with ac, 2 patients (5.1%) with ALC and 5 patients (3.6%) with ELC. CONCLUSION: The results of this study showed that in patients with ALC in comparison to OC, there are a decrease in total hospital stay, post operative hospital stay and major complications. LC should be considered as a first choice before open surgery.

LAPAROSCOPIC CHOLECYSTECTOMY (LC) in elective surgery has replaced open CHOLECYSTECTOMY (OC) . This study compared the safety and efficacy of these two methods in the treatment of symptomatic gallstones. This experimental parallel outcome study was carried out in Yazd . 140 cases were divided into two groups . 70 cases in LC (M.F=14.54) and 70 in OC (M.F=12.58). Respiratory complications in OC was two fold of LC, biliary injury in both groups were identical (1.4%). The mean hospital stay in OC was 4.08+ 1.9 days and in LC 1.57+0.75 days (P>0.001) . Also , the Mean of NPO time in post operative period in OC was 1.84+0.58 and in LC 1.50 + 0.23. In addition , 2.8% of patients in OC has wound infection and in one patient of LC has subcutaneous hemorrhage . LC provides a safe and effective treatment for most patients with symptomatic gallstones , Laparoscopy