Comparative Study of Operative Outcomes between Two and Single Incision Laparoscopic Cholecystectomy in Benign Gallbladder Diseases
Keywords:
two- incisions laparoscopic cholecystectomy, single- incision laparoscopic cholecystectomyAbstract
Background and Objective: Building on previous studies on reduced port laparoscopic cholecystectomy, single-incision laparoscopic cholecystectomy (SILC) and two-incision laparoscopic cholecystectomy (TILC), it was observed that TILC resulted in a shorter operative time compared to SILC whereas similar levels of operative blood loss, post-operative pain score at 24 hours, length of hospital stay and treatment cost. To further investigate these findings and establish clear statistical differences, This research aimed to continue the study by comparing two types of reduced port LC.
Method: A parallel randomized clinical trial was conducted at Mahasarakham hospital between June 1,2021 and May 31,2022. Eighty patients with benign gallbladder disease who underwent reduced port LC using conventional instruments and handmade glove port, were divided into TILC and SILC group equcelly.
Results: The majority of patients were female (57.55 : 75.0 %).There were no statistically significant differences of age (53.48 : 57.03 years p=0.176), body mass index (24.14 : 24.08 Kg/m2 p=0.95), length of hospital stay (2.05 : 2.13 days p=306), cost (25,883.81 : 26,196.04 Bahts p=0.611), cosmetic satisfaction score (9.2 : 9.15 p=0.805) and time to return to normal activity (5.2 : 5.08 days p=0.73), on the other hand operative time (31.15 : 47.08 minutes p=0.000), estimated blood loss (6.13 : 8.98 ml p=0.003) and post-operative pain score at 24 hours (1.53 : 2.15 p=0.025) were significantly differences.
Conclusion: TILC was more applicability and efficacy than SILC, be a preferred choice for reduced port LC using conventional instruments.
References
Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy: the new ‘gold standard’?. Arch Surg 1992;127(8):917-21. doi:10.1001/archsurg.1992.01420080051008
Hasbahceci M. Laparoscopic Cholecystectomy: What has changed over the last three decades? Clin Surg 2016;1(1):1166. [Cited Jan 1,2021]. Available from: https://shorturl.asia/Hahiu
Trichak S. Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc 2003;17(9): 1434-36. doi:10.1007/s00464-002-8713-1
Poom CM, Chan KW, Lee DW, Chan KC, Ko CW, Cheung HY, et al. Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 2003;17(10):1624-27. doi:10.1007/s00464-002-8718-9
Chuang SH. From multi-incision to single-incision laparoscopic cholecystectomy step-by-step: One surgeon’s selft-taught experience and retrospective analysis. Asian J Surg 2013;36(1):1-6. doi: 10.1016/j.asjsur.2012.06.002
Khantasa-ard P. Single incision laparoscopic cholecystectomy using hand-made glove port. Srinagarind Med J 2020;35(6):649-55.
Khantasa-ard P. Two incisions laparoscopic cholecystectmy by handmade glove port and additional trocar. Srinagarind Med J 2021;36(5):534-40.
Vorapongsathorn T, Vorapongsathorn S. Sample size calculation for research by G*Power program. Thail J Heal Promot Environ Heal 2018; 41(2):11-21.
Abaid RA, Cecconello I, Zilberstein B. Simplified laparoscopic cholecystectomy with two incisions. Arq Bras Cir Dig 2014;27(2):154-6. doi:10.1590/S0102-67202014000200014
Lee SC, Choi BJ, Kim SJ. Two-port cholecystectomy maintains safety and feasibility in benign gallbladder diseases: A comparative study. Int J Surg 2014;12(9):1014-19. doi:10.1016/j.ijsu.2014.06.017
Xu Y, Wang A, Dai Q, Fang Z, Li Z. Laparoscopic cholecystectomy with two incisions : an improved, feasible and safe technique with superior cosmetic outcomes. J Int Med Res 2020;48(12): 1-8. doi:10.1177/0300060520980589
Justo-Janeiro JM, Vincent GT, Vazquez de Lara F, Paredes RR, Orozco EP, Vazquez de Lara LG. One, two, or three ports in laparoscopic cholecystectomy?. Int Surg 2014;99(6):739-44. doi:10.9738/INTSURG-D-13-00234.1
Leow VM, Faizah MS, Sharifudin SM, Letchumanan VP, Yang KF, Manisekar KS. Two-incision three-port laparoscopic cholecystectomy: A feasible and safe technique. Med J Malaysia 2014;69(3): 129-32. [Cited Jan 1,2021]. Available from : https://pubmed.ncbi.nlm.nih.gov/25326354/
Prathanvanich P, Tharavej C, Udomsawaengsup S, Pungpapong S, Navicharern P. A prospective cohort study for simple new technique two-incision laparoscopic cholecystectomy. Poster Presented at the SAGES 2010 Annual Meeting. [Cited Jan 1,2021]. Available from : https://shorturl.asia/RZksU
Pariwattanasak J. Comparative study between modified two-incision and standard four-port laparoscopic cholecystectomy. Srinagarind Med J 2012;27(1):2-7.
Khan G, Islam MI, Shah Z, Hyder SH, Khan Z, Sadia HJ. Single incision laparoscopic cholecystectomy versus two incision laparoscopic cholecystectomy. Med Channel 2017;23(3):26-30. [Cited Jan 1,2021]. Available from : https://shorturl.asia/2FzbL
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Srinagarind Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
