Transumbilical single-port laparoscopic cholecystectomy for chronic cholecystitis with cholecystolithi-asis / 中华肝胆外科杂志

ABSTRACT

Objective To study the feasibility, safety and aesthetics of laparoscopic cholecystectomy using a single-port through the umbilicus in patients with chronic cholecystitis with cholecystolithiasis. Methods From Jan 2007 to Jun 2017, the clinical data of 4790 patients who underwent single-port, 4426 patients conventional three-ports, and 3304 patients two-ports laparoscopic cholecystectomy were retrospec-tively studied. Results There were no death in all the three groups. There were no significant differences in the incidences of postoperative bleeding, bile leakage, biliary tract injury and other significant short-term complications (all P>0. 05). The operation time of transumbilical single-port laparoscopic cholecystectomy was significantly longer than that of two-ports and three-ports laparoscopic cholecystectomy [(35. 3 ± 9. 0) min vs. (28. 4 ± 7. 2)min vs. (23. 3 ± 6. 4)min, P<0. 05]. Looking only in a single year, there was no significant difference in the operation time of the three groups in the year 2017 (P>0. 05). There were no significant differences among the three groups in intraoperative blood loss, first postoperative passing of flatus, postoperative pain, and length of hospital stay (all P>0. 05). The satisfaction score of surgical scar in the single-port group was higher than that in the two-ports and three-ports groups [ ( 9. 6 ± 1. 6 ) vs. (7. 6 ± 1. 9) vs. (6. 7 ± 2. 0), P < 0. 05]. Conclusions Transumbilical single-port laparoscopic cholecystectomy was safe and feasible, with good aesthetics and other advantages. It was more difficult than the traditional laparoscopic technique. After the learning curve, the operation time could be comparable to the three-ports technique.