A prospective controlled trial comparing single-incision and conventional laparoscopic cholecystectomy: caution before damage control

Abstract

Purpose: To evaluate the safety and feasibility of single-incision laparoscopic cholecystectomy (SILS-C) compared with conventional laparoscopic cholecystectomy (CLC).

Methods: Sixty-five patients (SILS-C: 35, CLC: 30) were prospectively enrolled and operated with conventional straight instruments. The postoperative pain scores at 6, 24 hours, and 1 week, nausea, vomiting, commencement of oral intake, hospital stay, resumption of normal activities and work and satisfaction levels were noted.

Results: Twenty-eight percent (10/35) SILS-C patients required introduction of additional trocars to complete the procedure. No patient required conversion to open. All the morbidity parameters were similar in both the groups, except that the seroma formation in the wound was significantly higher in the SILS-C group [SILS-C: 17% (6/35)/CLC: 0%, P=0.038]. One patient in SILS-C had a major bile duct injury.

Conclusions: SILS-C is safe and feasible with conventional instruments. However, caution needs to be exercised in view of a major bile duct injury and a higher rate of seroma formation in the wound.