Single-incision versus 3-port laparoscopic cholecystectomy in symptomatic gallstones: A prospective randomized study

Abstract

Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease. Single-incision laparoscopic surgery was developed with the aim of decreasing the invasiveness of conventional laparoscopy. The aim of this study was to compare the clinical outcome of single-incision laparoscopic cholecystectomy with 3-port laparoscopic cholecystectomy. From February 2014 to September 2016, 187 patients with symptomatic cholecystolithiasis were randomized to a single-incision laparoscopic cholecystectomy group (89 patients) or a 3-port laparoscopic cholecystectomy group (98 patients). The primary outcomes were a postoperative pain score (at 6hours and 1day) and patients of complications, while the secondary outcomes were operative time, estimated blood loss, opioid requirements, duration of hospital stay, and patient satisfaction with aesthetic effects. When comparing 3-port laparoscopic cholecystectomy and single-incision laparoscopic cholecystectomy, there were differences in the (mean±standard deviation) operative time (58.9±18.6minutes vs 45.2±11.8minutes; P<.001), success rate (93% vs 99%; P<.01), conversion rate (7% vs 1%; P<.001), and aesthetic score (7.9±1.6 vs 6.7±1.4; P=.008). There were no statistically significant differences in estimated blood loss, postoperative pain, opioid requirement, complications, and hospital stay between both groups. Single-incision laparoscopic cholecystectomy is a safe and feasible procedure in selected patients. The main advantage is the superior aesthetic results, while the main disadvantage is a greater operative time with some technical difficulties.