Background: Laparoscopic cholecystectomy (LC) requires expensive equipment and special training. Mini-lap cholecystectomy (MLC) has no start-up costs but no large series from a single centre has been reported as the procedure is considered hazardous because of inadequate exposure of the surgical field. Methods: We retrospectively reviewed the outcome of 737 cholecystectomies performed through a 3-5-cm transverse subcostal incision and compared the results to published series of laparoscopic cholecystectomy. Results: The operating time (61.6 min; range 35-1 30), conversion rate (4%), rate of postoperative complications (3.6%), bile duct injuries (0.3%), number of analgesic doses required (3.4; range 3-8), duration of postoperative hospital stay (1.4; range 1-15 days), and the time off work ( 13.3 days; range 8-61 ) compare well with the reported results of laparoscopic and MLC. Ninety-three per cent of the patients were followed up for a median period of 28.4 months and none developed biliary stricture. Conclusions: Mini-lap cholecystectomy is considered a safe, viable alternative to LC in the Third World.

Hundred patients with symptomatic gallstone disease underwent laparosopic cholecystectomy between June 1996 and August 1997. There were 78 females and 22 males, with a mean age of 46.2 (SO 17.8; range 21 to 85) years. The common presentations were right upper abdominal pain (n=66), acute cholecystitis (n=8) and history of jaundice (n=II). Sixteen patients underwent ERCP for suspected CBO stones. Endoscopic papillotomy and basketing cleared the CBO of all calculi in 12. Three patients required c'Jnversion to open cholecystectomy because of dense adhesions (n=2) and to control intraoperative haemorrhage (n=I). Mean operating time was 67.2 (SO 39.2; range 22 to 186) minutes. The mean requirement of analgesics was 2.8 (SO 1.3; range 2 to 5) doses and post-operative hospital stay was 1.6 (SO 1.4; range I to 7) days. All patients resumed normal activity within 14 days of operation and are well and satisfied with their operation at a median follow up of8.6 months. MJAFI 1998; 54: 185-187