Journal of Gastrointestinal Surgery

, Volume 15, Issue 4, pp 614–622

Evaluating Systemic Stress Response in Single Port vs. Multi-Port Laparoscopic Cholecystectomy

Authors

    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
    • Department of Biosurgery and Surgical Technology, Division of Surgery, Academic Surgical UnitImperial College London
  • Mikael H. Sodergren
    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
  • Alec Aslanyan
    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
  • Victoria J. Wright
    • Division of Infectious Diseases, Department of MedicineImperial College London
  • Sanjay Purkayastha
    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
  • Ara Darzi
    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
  • Paraskevas Paraskeva
    • Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical UnitSt Mary’s Hospital
Original Article

DOI: 10.1007/s11605-011-1432-y

Cite this article as:
McGregor, C.G.C., Sodergren, M.H., Aslanyan, A. et al. J Gastrointest Surg (2011) 15: 614. doi:10.1007/s11605-011-1432-y

Abstract

Background and Aims

Acute-phase proteins and inflammatory cytokines mediate measurable responses to surgical trauma, which are proportional to the extent of tissue injury and correlate with post-operative outcome. By comparing systemic stress following multi-port (LC) and single-incision laparoscopic cholecystectomy (SILC), we aim to determine whether reduced incision size induces a reduced stress response.

Methods

Thirty-five consecutive patients were included, 11 underwent SILC (mean ± SEM; age 44.8 ± 3.88 year; BMI 27 ± 1.44 kg/m2) and 24 underwent LC (56.17 ± 2.80 year; 31.72 ± 1.07 kg/m2, p < 0.05). Primary endpoint measures included levels of interleukin-6 and C-reactive protein measured pre- and post-operatively. Length-of-stay (LOS) and postoperative morbidity were secondary endpoints.

Results

No statistically significant differences were found between SILC and LC for interleukin-6 and C-reactive protein levels, LOS and duration of surgery. There was also no correlation between systemic stress response and operative parameters. There were no intra-operative complications.

Conclusion

SILC appears to be a safe, feasible technique with potential advantages of cosmesis, reduced incisional pain, and well-being recommending its use. These data indicate no difference in systemic stress and morbidity between SILC and LC. A larger, multi-centred, randomised prospective trial is warranted to further investigate and confirm this finding.

Keywords

Cytokines Acute phase response Single incision laparoscopic surgery (SILS) Cholecystectomy

Copyright information

© The Society for Surgery of the Alimentary Tract 2011