Does single incision laparoscopic cholecystectomy increases the bile duct injury?

Abstract

Purpose: Single-incision laparoscopic cholecystectomy (SILC) is relative safe. But it is difficult to proceed safely in all cases. There is concern about the bile duct injury. So the purpose of this study was to evaluate that SILC actually increases the bile duct injury. Method: A total of 2080 cases were performed laparoscopic cholecystectomy between Mar. 2010 and Dec. 2016 Konyang University Hospital. We divided two group based on whether there was injury to the bile duct. (no injury group; n = 2065, 99.3% vs. injury group; n = 15, 0.7%). Result: This study includes 2080 cases with 1015 male (48.8%) and 165 female (51.2%) patients. Age was significantly higher the injury group than no injury group (70.1 ± 11.7 vs. 56.6 ± 16.0, p = 0.001). Operative time was significantly longer in the injury group (54.8 ± 22.9 min vs. 88.3 ± 41.7min, p < 0.001). Bleeding loss (21.8 ± 43.7 ml vs. 70.8 ± 94.9 ml, p = 0.001), hospital stay days (3.0 ± 2.8 days vs. 12.0 ± 7.4 days, p < 0.001) and hemovac insertion (171(8.3%) vs. 9(60.0%), p < 0.001 ) were higher in the injury group than no injury group. However there was no pathologic difference between pathologic results (p = 1.000). Also in operation type, both CLC and SILC were no difference between the two groups, (p = 0.121). In multivariate analysis, operation type was no significant risk factor (p=0.291 OR 1.924). Conclusion: According to the our results, SILC does not actually involve bile duct injury in selected patiets.