Single-port Laparoscopic Cholecystectomy: Comparative Study of Consecutive Initial 206 Cases

ABSTRACT

PURPOSE: Laparoscopic cholecystectomy has been the standard of care for gallbladder diseases since the late 1980s. Many surgeons have rapidly adopted single-port laparoscopic cholecystectomy for gallbladder pathologies. The aim of the current study was to analyze clinical outcome in initial single-port laparoscopic cholecystectomy. METHODS: Analysis of data from 206 consecutive single-port laparoscopic cholecystectomies performed between May 2008 and Jun 2012 was conducted retrospectively. We divided the patients into four groups according to surgery period - period I (n=56), II (n=50), III (n=50), and IV (n=50), consecutively. During each procedure only one longitudinal transumbilical incision, 1.5 to 2.0 cm in length, was made in order to access the abdominal cavity. One of the various single-port trocars was used for the procedure. Standard laparoscopic instruments were used in performance of cholecystectomy. RESULTS: Patients' demographics did not differ among the groups. Of the 14 cases that were converted to conventional laparoscopic surgery, seven were part of period I, one of II, five of III, and one of IV. Mean operation time for single-port laparoscopic cholecystectomy in each group was 71.6, 58.2, 69.1, and 53.3 minutes, in order. There were two operative complications in period I, which were managed successfully with laparoscopic surgery. No statistical difference in hospital stay was observed among the groups. CONCLUSION: Single-port laparoscopic cholecystectomy can be performed safely for various gallbladder lesions in selected cases, and the operation time improved with accumulation of cases.