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Abstract
The aim of this pilot study was to describe our initial experience with single-incision
laparoscopic cholecystectomy (SILC) using conventional laparoscopic equipment in comparison
with concurrent patients undergoing conventional multiincision laparoscopic cholecystectomy.
During the 7-month study period, data from all consecutive patients undergoing SILC
by two surgeons were retrospectively analyzed and compared with data from patients
undergoing conventional laparoscopic cholecystectomy by the same surgeons during the
same time period. Outcomes measures included completion rate of attempted SILC, operative
time, length of hospital stay, postoperative pain, and assessment of complications.
From 51 laparoscopic cholecystectomies performed during the study period, 29 were
attempted using single-incision technique and 22 were performed using the conventional
four incisions. Of the attempted SILC cases, 14 (48%) were successfully completed,
with the remainder requiring one to three additional skin incisions. There were no
conversions to open in either group. Operative time was significantly longer in SILC
cases compared with conventional laparoscopic cholecystectomy (85 versus 67 minutes;
p = 0.01). There was a tendency toward greater postoperative pain in the SILC group.
No substantial difference in complications was identified.
SILC using conventional laparoscopic instrumentation is an effective alternative to
standard four-incision laparoscopic cholecystectomy in selected patients. Development
of a standardized technique and additional experience is needed for more consistent
success. Additional studies of SILC are needed to demonstrate safety, define selection
criteria, and determine any benefits over conventional laparoscopic cholecystectomy.