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. 2014 Feb;16(2):177-82.
doi: 10.1111/hpb.12100. Epub 2013 Apr 4.

Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy

Norihiro Sato  1 , Kei Yabuki, Kazunori Shibao, Yasuhisa Mori, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi
Affiliations

Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy

Norihiro Sato et al. HPB (Oxford). 2014 Feb.

Abstract

Background: A prolonged operative time is associated with adverse post-operative outcomes in laparoscopic surgery. Although a single-incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown.

Methods: A total of 20 clinical variables were retrospectively reviewed to identify factors for a prolonged operative time (longer than 3 h) in a total of 220 consecutive patients undergoing SILC.

Results: The median operative time was 145 min (range, 55-435) and a prolonged operative time was required in 62 patients (28%). Independent factors that predict a prolonged operative time as identified through multivariate analysis were body mass index (BMI) (P = 0.009), acute cholecystitis (P < 0.001) and operator (resident or staff surgeon) (P < 0.001). Furthermore, a prolonged operative time was significantly associated with an increased amount of intra-operative blood loss (P < 0.001) and a prolonged stay after surgery (P < 0.001).

Conclusions: These findings suggest that a higher BMI, acute cholecystitis and a resident as an operator significantly increase the duration of SILC procedures.

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