Impact of single-port cholecystectomy on postoperative pain

Background: This study compared postoperative pain following four-port laparoscopic cholecystectomy (LC) and single-port cholecystectomy (SPC). Method: This prospective, quasi-randomized, single-centre trial focusing on postoperative pain included 49 patients undergoing elective surgery with either a conventional LC, or SPC using a surgical glove port. Postoperative pain was evaluated using a visual analogue scale (VAS) and postoperative analgesic use as primary outcome measures. Total duration of operation, length of hospital stay, blood test results on the day after surgery and total port cost were secondary outcome measures. Results: Twenty-five LCs and 24 SPCs were undertaken. The VAS score on day 1 after surgery was significantly less in the SPC group than in the LC group: median (range) 24 (12-38) versus 45 (33-57) mm (P = 0.002). Significantly fewer patients in the SPC group required analgesia (9 of 24 versus 19 of 25 in the LC group; P = 0.007). There were no significant differences in total duration of operation, length of hospital stay, and blood test results on the day after surgery. Conclusion: Single-port surgery using a surgical glove port reduces postoperative pain compared with conventional LC. Registration number: UMIN000002539 (http://www.umin.ac.jp/ctr/index.htm).