Evaluation of pain scores after single-incision and conventional laparoscopic cholecystectomy: A randomized control trial in a rural Indian population

Introduction: Single-incision laparoscopic cholecystectomy (SILC) is considered to be less invasive and have less morbidity than conventional laparoscopic cholecystectomy (CLC). However, there is a relative paucity of data regarding postoperative pain scores in rural Indian populations following SILC. Also, data pertaining to the applicability of SILC in rural Indian population are scant. Methods: In the present randomized control trial, pain scores after SILC and CLC were evaluated. Sixty patients with gallstone disease were randomly assigned to one of two groups with 30 patients each: the CLC group and the SILC group. Postoperative pain scores were recorded on the visual analog scale at 8 hours, 24 hours and 7 days after surgery. Results: The patients were comparable with respect to age, sex and BMI. Operative time was longer for the SILC group (47.73 +/- 5.57 min vs 69.53 +/- 8.96 min; P < 0.0001). The pain scores were similar in both groups at 8 hours (3.61 +/- 0.41 vs 3.50 +/- 0.51; P = 0.36) and 24 hours (3.30 +/- 0.59 vs 3.20 +/- 0.40; P = 0.44) postoperatively. On day 7, the SILC group had lower pain scores than the CLC group (2.56 +/- 0.56 vs 1.16 +/- 0.37; P < 0.01). Conclusion: There was no distinct advantage to SILC with regard to immediate postoperative pain. Pain was significantly less (P < 0.01) in the SILC group on postoperative day 7.