Single incision laparoscopic cholecystectomy: for what benefit?

HPB (Oxford). 2013 Jun;15(6):433-8. doi: 10.1111/j.1477-2574.2012.00612.x. Epub 2012 Nov 19.

Abstract

Background: A single-incision laparoscopic cholecystectomy (SILC) was developed to improve outcomes as compared with the four-port classic laparoscopic cholecystectomy (CLC). Any potential benefits associated with a SILC have been suggested by previous studies reporting few patients with different surgical techniques. The aim of this study was to describe the experience with a standardized SILC as compared with CLC.

Methods: From June 2010 to January 2012, 40 patients underwent a SILC [median age: 47.5 years (25-92)] and operative and peri-operative data were prospectively collected. Over the same period, 37 patients underwent a CLC. A 10-point visual analogue scale (VAS) was used for qualitative data. The costs of SILC and CLC were also compared.

Results: For those patients undergoing a SILC the median operating time was 70 min (24-110). There were no conversions. An additional trocar was necessary in 16 patients. Four patients developed post-operative complications. The median immediate post-operative pain score was 5 (0-10). The median quality of life and cosmetic satisfaction at the initial post-operative visit were 10 (6-10) and 10 (5-10), respectively (VAS). Although the surgical results of both groups were similar, post-operative complications were exclusively reported in the SILC group (two incisional hernias).

Conclusion: Standardization of SILC is possible but associated with an important rate of additional trocar placement and a disturbing rate of incisional hernias.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Cholecystectomy, Laparoscopic / adverse effects
  • Cholecystectomy, Laparoscopic / economics
  • Cholecystectomy, Laparoscopic / methods*
  • Female
  • Hernia, Abdominal / etiology
  • Hospital Costs
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / etiology
  • Patient Satisfaction
  • Quality of Life
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome