Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a retrospective comparative study

Abstract

Background: Recent reports have suggested that single-incision laparoscopic cholecystectomy (SILC) is technically feasible. We present our initial retrospective comparative study between SILC and conventional laparoscopic cholecystectomy (CLC) with respect to perioperative outcomes.

Methods: The authors reviewed 100 SILC and 100 CLC performed by a single surgeon from May 2009 to July 2010 at the Shengjing Hospital of China Medical University. All the procedures were completed by using the standard trocars and rigid laparoscopic instruments. Demographic data, operating time, estimated blood loss, analgesics requirements, days to oral food intake, and complications were compared.

Results: Of the attempted SILC cases, 99 cases (99%) were successfully performed, with 1 case requiring three additional trocars for safe dissection because of existence of accessory bile duct. In the CLC group, all the procedures were successfully completed (three trocars) without conversion to open cholecystectomy. Compared with the CLC group, there was a lower mean estimated blood loss (17.9 ± 15.8 mL versus 27.5 ± 13.9 mL; P = .000) and analgesic requirement (10 versus 23; P = .024) in the SILC group. However, there was no difference between SILC and CLC in operating time (53.5 ± 24.0 minutes versus 49.2 ± 13.8 minutes; P = .163), days to oral food intake (1.8 ± 0.8 days versus 1.8 ± 0.7 days; P = .873), and postoperative complication rate (2% versus 0%; P = .155).

Conclusion: SILC is feasible using the standard trocars and rigid laparoscopic instruments, and it is an effective alternative to CLC in selected patients. However, further clinical studies are necessary to confirm its real benefits.