4.5 Article

Single-Incision Laparoscopic Cholecystectomy: a Single-Centre Experience of 1469 Cases

Journal

JOURNAL OF GASTROINTESTINAL SURGERY
Volume 26, Issue 4, Pages 831-836

Publisher

SPRINGER
DOI: 10.1007/s11605-021-05231-7

Keywords

Single incision; Laparoscopic cholecystectomy; Safety

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This study retrospectively analyzed the outcomes of 1469 cases of single-incision laparoscopic cholecystectomy (SILC) performed at Osaka Police Hospital from May 2009 to December 2020. The results showed that the median operative time and blood loss of SILC were 96 minutes and 0 mL, respectively. Intraoperative complications included common bile duct injury and right hepatic artery injury, with no other organ injury observed. Postoperative complications and incisional hernias occurred in a small percentage of patients. The study concluded that SILC can be performed safely without an increase in complications.
Background Despite having once been extensively used for cosmetics or pain reduction, the use of single-incision laparoscopic cholecystectomy (SILC) has declined in recent years due to technical difficulties and a reported increase in complications. Since the introduction of SILC in 2009, our hospital has been actively involved with this technique. Our experience suggests that SILC is not a difficult procedure and can be safe and useful, with particularly excellent cosmetic outcomes. This study retrospectively details the outcomes of SILC at our hospital. Method Data on 1469 cases of SILC performed on a waitlist basis at Osaka Police Hospital from May 2009 to December 2020 were collected and retrospectively analysed. Results The median operative time and blood loss were 96 min and 0 mL, respectively. A total of 46 patients (3.1%) required conversion surgery, including 36 needing additional ports and 10 requiring laparotomy. Intraoperative complications included common bile duct injury in 1 patient (0.07%) and right hepatic artery injury in 1 patient (0.07%), with no other organ injury. Postoperative Clavien-Dindo 3 or higher complications were observed in 18 patients (1.2%). Incisional hernias occurred in 15 patients (1.0%). The median postoperative hospital stay was 3 days. Conclusion This study showed that SILC can be performed safely without any increase in complications, as reported previously. Granted that it is performed safely, SILC may be a useful technique due to its superior cosmetic outcomes or pain reduction.

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