[Alternatives to minimally invasive cholecystectomy].

Open endoscopic minimally invasive cholecystectomy procedures were developed as alternatives to laparoscopic as well as conventional cholecystectomy. The procedures: 1. Open endoscopic microsurgical removal of gallbladder (with or without laser) a 2-2.5 centimeters verticular median incision between the xiphoid and umbilicus. 118 operations with this technique has been performed. 2. Open endoscopic minimally invasive removal of gallbladder with 2.6-4 cms verticular median incision (63 patients) and 4.1-6 cms verticular median incision. Eighteen operations with this technique have been performed (7 choledocholithiasis, 4 accessory bile duct to the right liver lobe etc). Since 1990 we performed 200 consecutive open endoscopic minimally invasive cholecystectomy with no death and a morbidity rate of 1%. There were 161 women and 39 men (19 to 82 years). All gallbladder diseased patients are candidates for this procedures including patients with acute cholecystitis, empyema of the gallbladder, choledocholithiasis, large gallstones or previous abdominal surgery. These procedures are designed as safe, less expensive alternatives to laparoscopic or conventional cholecystectomy.