Morton C E
Am Surg. 1985 Mar;51(3):168-9.
During an era when cost containment has become increasingly important, a new approach to elective cholecystectomies through a 4 to 5 cm incision is reported. Over an approximately 2-year period, 96 patients have undergone "mini-cholecystectomies" with intraoperative cholangiograms. Six of these patients have had concomitant common bile duct explorations. The average postoperative stay was 2.5 days. The average procedure lasted 45 minutes. Pain medication postoperatively was required less frequently than with the routine subcostal incision. Time away from work was greatly reduced. No complications were encountered. When a more complicated cholecystectomy is discovered, which may place the patient in danger, the small incision can be easily lengthened in order to provide better exposure and thus aid in dissection. On the basis of almost 600,000 cholecystectomies performed per year, hospital costs ranging from $100 to $150 per day, and the procedure being acceptable in 80 per cent of the elective procedures, the potential yearly cost-savings could range up to $250,000,000 per year when this procedure is used.
在成本控制日益重要的时代，有报告称一种通过4至5厘米切口进行择期胆囊切除术的新方法。在大约两年的时间里，96例患者接受了带有术中胆管造影的“迷你胆囊切除术”。其中6例患者同时进行了胆总管探查。术后平均住院时间为2.5天。平均手术持续时间为45分钟。术后使用止痛药物的频率低于常规肋下切口手术。患者的误工时间大幅缩短。未出现并发症。当发现更复杂的胆囊切除术可能使患者处于危险中时，小切口可轻松延长，以提供更好的视野，从而有助于解剖。基于每年进行近60万例胆囊切除术、每天住院费用在100美元至150美元之间，以及该手术在80%的择期手术中可行，采用此手术每年潜在的成本节约可达2.5亿美元。
