Comparison of single incision versus multiple incision laparoscopic cholecystectomy: a meta analysis

Abstract

Introduction: Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallbladder stones. Single incision laparoscopic cholecystectomy (SILC) has emerged to achieve fewer complications and better cosmesis. This meta-analysis aims to find a reliable, risk-free, or at least of comparative risk versus the standard surgical procedure. This study aims to compare SILC with multiple incision laparoscopic cholecystectomy (MILC) in terms of mean operative time, various post-operative complications and aesthesis. Methodology: Articles included were obtained using PUBMED databases. The studies evaluated were restricted to only those with human subjects and those studies that are in English. All articles included in this study met the inclusion criteria: the study was an RCT, SILC was compared to MILC, features at least one year follow-up and the population were all adults. Exclusion criteria included: patients with cholecystitis, suspicion or proved persistence of a choledocholithiasis, necrotic pancreatitis, BMI higher than 30 or a history of liver disease or upper abdominal surgery, published more than 5 years, non-human trials and studies with incomplete data. Results: Mean operative time of surgery is significantly longer for the SILC group. In terms of cosmesis and patient satisfaction rates, SILC showed optimum results. Although most complications were equal with both techniques, presence of incisional hernia was higher in the SILC group. Conclusion: This study concludes that SILC is a feasible, safe and adaptable technique. The benefits of SILC in terms of cosmetic and patient satisfaction will spearhead the use of this technique in the future generations.