Single port laparoscopic cholecystectomy compared to the standard laparoscopic cholecystectomy
DOI:
https://doi.org/10.18203/2349-2902.isj20191275Keywords:
SILC, SLC, Gallbladder, LaparoscopicAbstract
Background: Efforts to improve outcomes of laparoscopic cholecystectomy heralded the advent of single incision laparoscopic cholecystectomy. The objective of this study was to evaluate and compare single port laparoscopic cholecystectomy to the standard laparoscopic cholecystectomy with respect to time required for surgery, postoperative pain, morbidity and complications.
Methods: This comparative randomized study was conducted in M.L.B. Medical College, Jhansi among 124 patients. 74 patients were included in the three port laparoscopic cholecystectomy group and 50 in the single port laparoscopic cholecystectomy group. Informed consent was taken. All patients were operated under general anesthesia. Statistical analysis was using independent t-test and chi- square test.
Results: The mean operative time was slightly longer in SILC (group I) as compared to CLC/SLC (group II). Postoperative pain on VAS scale in group I after 6 hours (1st day score) was 2.44 in group I and 2.73 in group II (CLC/SLC). But on 2nd day in SILC 1.40 and in CLC/SLC it was 1.81. In SILC (group I) 4 patients out of 50 (8%) developed seroma and 2 patients out of 50 (4%) developed Biliary peritonitis due to the slipped dip. And in SLC/CLC (group II) 3 patients out of 74 (4.05%) developed seroma.
Conclusions: SILC can be an effective alternative to traditional CLC/SLC, with the added benefit of minimized scarring and a shorter length of stay. This technique can be performed safely for patients with a multitude of gallbladder diseases without resulting in additional complications.
References
Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Domini I. One wound laparoscopic cholecyst-ectomy. Br J Surg. 1997;84:695.
Litynski GS. Highlights in the history of laparoscopy. Frankfurt, Germany: Barbara Bernert Verlag. The Journal of the American Association of Gynecologic Laparoscopists. 1997;4(5):624.
Reynolds W. The first laparoscopic cholecystectomy. JSLS. 2001;5(1):89-94.
Kehagias l, Karamanakos SN, Markopoulos GA, Kalfarentzos F. Benefits and drawbacks of SILC cholecystectomy: a report of 60 SILC cholecystectomies with conventional instruments from an academic centre. Surg Innov. 2012;19(4):438-45.
Tacchina R, Greco F, Matera D. Single-incision laparoscopic cholecystectomy surgery without a visible scar. Surg Endosc. 2009;23:896-9.
Gupta P, Agarwal NK, Gupta P, Singh SP. To compare single incision laparoscopic cholecystectomy with standard laparoscopic cholecystectomy for treatment of symptomatic cholelithiasis:a prospective randomized study. Int Surg J. 2016;3:900-4.
Trastulli S, Cirocchi R, Desiderio J, Guarino S, Santoro A, Parisi A, et al. Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy. Br J Surg. 2013;100:191-208.
Joseph S, Moore BT, Sorensen GB, Earley JW, Tang F, Jones P, et al. Single-incision laparoscopic cholecystectomy: a comparison with the gold standard. Surg Endosc. 2011;25:3008-15.
Wagner MJ, Kern H, Hapfelmeier A, Mehler J, Schoenberg MH. Single-port cholecystectomy versus multi-port cholecystectomy: a prospective cohort study with 222 patients. World J Surg 2013;37:991-8.
Gangl O, Hofer W, Tomaselli F, Sautner T, Függer R. Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC)-a matched pair analysis. Langenbecks Arch Surg. 2011;396:819-24.
van den Boezem PB, Kruyt PM, Cuesta MA, Sietses C. Singleincision versus conventional laparoscopic cholecystectomy: a case control study. Acta Chir Belg. 2012;112:374-7.
Hong TH, You YK, Lee Kh. Transumbilical single-port laparoscopic cholecystectomy: scarless cholecystectomy. Surg Endosc. 2009;23:1393-7.
Bucher P, Pugin P et al. "Single Port Access Laparoscopic Cholecystectomy (with video)". World J Surg. 2009;33(5):1015-9.
Sinha R, Transumbilical single-incision laparoscopic cholecystectomy with conventional instruments and ports: the way forward? J Laparoendoscopic Adv Surg Tech. 2011;21(6):497-503.
Mehmood Z, Subhan A, Rasul S. Single Incision Laparoscopic Cholecystectomy (SILC). Pak J Med Sci. 2011;27(1):38-40.
Priyadarshan AJ, Yadav SP. Prospective Observational Study of Single-Site Multiport Per-umbilical Laparoscopic Endosurgery versus Conventional Multiport Laparoscopic Cholecystectomy: Critical Appraisal of a Unique Umbilical Approach. Hindawi publishing corporation, Min Inv Surg. 2014:14:1-9.
Culp BL, Cedillo VE, Arnold DT. Single-incision laparoscopic cholecystectomy versus traditional four-port cholecystectomy. Proc (Bayl Univ Med Cent). 2012;25(4):319-23.