Literature DB >> 23372363

Single-incision vs three-port laparoscopic cholecystectomy: prospective randomized study.

Ming-Xin Pan1, Ze-Sheng Jiang, Yuan Cheng, Xiao-Ping Xu, Zhi Zhang, Jia-Sheng Qin, Guo-Lin He, Ting-Cheng Xu, Chen-Jie Zhou, Hai-Yan Liu, Yi Gao.   

Abstract

AIM: To compare the clinical outcome of single-incision laparoscopic cholecystectomy (SILC) with three-port laparoscopic cholecystectomy (TPLC).
METHODS: Between 2009 and 2011, one hundred and two patients with symptomatic benign gallbladder diseases were randomized to SILC (n = 49) or TPLC (n = 53). The primary end point was post operative pain score (at 6 h and 7 d). Secondary end points were blood loss, operation duration, overall complications, postoperative analgesic requirements, length of hospital stay, cosmetic result and total cost. Surgical techniques were standardized and all operations were performed by one experienced surgeon, who had performed more than 500 laparoscopic cholecystectomies.
RESULTS: One patient in the SILC group required conversion to two-port LC. There were no open conversions or major complications in either treatment groups. There were no differences in terms of estimated blood loss (mean ± SD, 14 ± 6.0 mL vs 15 ± 4.0 mL), operation duration (mean ± SD, 41.8 ± 17.0 min vs 38.5 ± 22.0 min), port-site complications (contusion at incision: 5 cases vs 4 cases and hematoma at incision: 2 cases vs 1 case), total cost (mean ± SD, 12 075 ± 1047 RMB vs 11 982 ± 1153 RMB) and hospital stay (mean ± SD, 1.0 ± 0.5 d vs 1.0 ± 0.2 d) , respectively. TPLC had a significantly worse visual analogue pain score at 8 h after surgery (mean ± SD, 3.5 ± 1.6 vs 2.0 ± 1.5), however, the scores were similar on day 7 (mean ± SD, 2.5 ± 1.4 vs 2.0 ± 1.3). Cosmetic satisfaction, as determined by a survey at 2 mo follow-up favored SILC (mean ± SD, 8 ± 0.4 vs 6 ± 0.2).
CONCLUSION: SILC is a safe and feasible approach in selected patients. The main advantages are a better cosmetic result and less pain.

Entities:  

Keywords:  Cholecystectomy; Laparoscopic; Laparoscopic cholecystectomy; Randomized; Single-incision

Mesh:

Year:  2013        PMID: 23372363      PMCID: PMC3554825          DOI: 10.3748/wjg.v19.i3.394

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


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4.  Tripartite comparison of single-incision and conventional laparoscopy in cholecystectomy: A multicenter trial.

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5.  Single-incision laparoscopic cholecystectomy with curved versus linear instruments assessed by systematic review and network meta-analysis of randomized trials.

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7.  Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis.

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10.  Laparoendoscopic single-site cholecystectomy vs three-port laparoscopic cholecystectomy: a large-scale retrospective study.

Authors:  Yuan Cheng; Ze-Sheng Jiang; Xiao-Ping Xu; Zhi Zhang; Ting-Cheng Xu; Chen-Jie Zhou; Jia-Sheng Qin; Guo-Lin He; Yi Gao; Ming-Xin Pan
Journal:  World J Gastroenterol       Date:  2013-07-14       Impact factor: 5.742

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