Laparoscopic Cholecystectomy (LC) : A Comparison Study between the Single-incision and the Three-port LC

Abstract

Background and objectives: Single incision laparoscopic cholecystectomy (SILC)  has been increasingly performed. It seems plausible that SILC will be associated with less incision wounds and pain compared to the 3-port laparoscopic cholecystectomy (LC). The objective of this study was to evaluate and compare the surgical outcomes of the SILC and LC methods.

Methods: Of the 50 patients at Udonthani Hospital who were enrolled from December 2011 and October 2012 in this prospective study, 25 patients underwent  single incision laparoscopic cholecystectomy (SILC group); 25 patients underwent  3-port laparoscopic cholecystectomy (LC group). Demographic data, clinico-pathologic characteristics, operative and hospitalization times, postoperative pain score days 1, 2 and 3 and pain sites between the two groups were analyzed. The Pearson Chi-Square test, Mann-Whitney U test, Student’s t-test and Fisher’s exact test were used for statistical analysis.

Results: The SILC group was younger than the LC group. The BMI was higher in the SILC group than the LC group (23.08± 4.95 vs 22.81±4.31 kg/m2, p=0.837).  Estimate blood loss in the SILC group was less than in the LC group (14.80±9.26 vs 15.40±9.34 cc, p=0.719) . The operative time was longer in the SILC group than the LC group (64.60±28.43 vs 45.40±14.00  min, p=0.005). The mean hospitalization period in the SILC group was shorter than the LC group (4.28±0.89 vs 4.84±1.49 days, p=0.165). The total cost was higher in the SILC group than the LC group  (29,350.60±3,354.41 vs 29,239.80±3,026.57 baht, p=0.903). Average pain score on postoperative days 1, 2, 3 of SILC group and (LC group) were 5.20 (4.84) (p=0.486), 3.44 (3.48) (p=0.901), 1.72 (2.20) (p=0.159), respectively. The umbilical pain for the SILC group versus the LC group is 25(100%)/ 24(96%), the epigastrium pain is 7(28%)/18(72%) and right hypochondrium pain is 2(8%)/17(68%).

Conclusion: The single incision laparoscopic cholecystectomy via trans-umbilicus is safe and give results in fewer incision wounds and less wound pain. Operative time for SILC group was longer, and the proportions of patients suffering epigastrium and right hypochondrium  pains were significantly higher in the LC group.