World Journal of Surgery

, Volume 35, Issue 2, pp 289–293 | Cite as

A Case–control Study of Single-Incision Versus Standard Laparoscopic Cholecystectomy

  • Stephen Kin Yong Chang
  • Chee Wei Tay
  • Ralph Allan Bicol
  • Yang Yang Lee
  • Krishnakumar Madhavan



Single-incision laparoscopic cholecystectomy (SILC) has been increasingly performed recently. Although it seems plausible that SILC will be associated with less pain compared to standard 4-port laparoscopic cholecystectomy (LC), there is currently no conclusive comparative study on the postoperative pain issues of SILC against LC.


In this retrospective, case–control study, 30 patients who had SILC over a 6-month period were compared with a matched (sex, age group, race) group of 30 patients who underwent LC. Verbal pain score (VPS) on postoperative days (POD) 1, 2, 3, and 5; pain sites; analgesic requirement; and number of days (NoD) required to return to normal activities were compared.


There were 4 (13%) acute cholecystitis cases in each group. Average VPS on POD 1, 2, 3, and 5 of SILC and (LC) cholecystectomy patients were 4.53 (5.14) (P = 0.09), 3.43 (3.83) (P = 0.36), 2.07 (2.52) (P = 0.25), and 1.13 (1.24) (P = 0.69), respectively. In the SILC group, 26 patients (87%) had umbilical pain, whereas in the LC group, 25 patients (83%) had similar symptoms. Epigastric pain was experienced by 5 patients in the two groups, and RHC pain was experienced by 1 patient in the SILC group (3%) and 2 patients in the LC group (7%). The SILC and the LC patients required 4.00 and 4.90 days (P = 0.09) of paracetamol, respectively, to control pain. The NoD required before return to normal activity in the SILC and LC groups was 5.97 days and 7.79 days (P = 0.008), respectively.


There was no statistically significant difference in postoperative pain, pain site and analgesia requirement; however, patients who underwent SILC returned to their normal activity 1.8 days earlier than the LC patients. Larger RCTs are needed to compare postoperative outcomes between SILC and LC.


Postoperative Pain Laparoscopic Cholecystectomy Normal Activity Analgesia Requirement Laparoscopic Cholecystectomy Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are grateful to Yu Rui Qi and Shen Liang for their contributions to the success of this study.




  1. 1.
    Rao PP, Bhagwat SM, Rane A et al (2008) The feasibility of single port laparoscopic cholecystectomy: a pilot study of 20 cases. HPB 10:336–340CrossRefPubMedGoogle Scholar
  2. 2.
    Tacchino R, Greco F, Matera D et al (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899CrossRefPubMedGoogle Scholar
  3. 3.
    Chow A, Purkayastha S, Aziz O et al (2009) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714CrossRefPubMedGoogle Scholar
  4. 4.
    Ersin S, Firat O, Sozbilen M et al (2009) Single-incision laparoscopic cholecystectomy: is it more than a challenge? Surg Endosc 24:68–71CrossRefPubMedGoogle Scholar
  5. 5.
    Bucher P, Pugin F, Buchs N et al (2009) Single port access laparoscopic cholecystectomy (with video). World J Surg 33:1015–1019CrossRefPubMedGoogle Scholar
  6. 6.
    Hernandez JM, Morton CA, Ross S et al (2009) Laparoendoscopic single site cholecystectomy: the first 100 patients. Am Surg 75:681–686PubMedGoogle Scholar
  7. 7.
    Bucher P, Pugin F, Morel P et al (2009) From single-port access to laparoendoscopic single-site cholecystectomy (letter). Surg Endosc 24:234–235CrossRefPubMedGoogle Scholar
  8. 8.
    Hodgett SE, Hernandez JM, Morton CA et al (2009) Laparoendoscopic single site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192CrossRefPubMedGoogle Scholar
  9. 9.
    Ponsky TA (2009) Single port laparoscopic cholecystectomy in adults and children: tools and techniques. J Am Coll Surg 209:e1–6 epub Sept 3Google Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Stephen Kin Yong Chang
    • 1
  • Chee Wei Tay
    • 1
  • Ralph Allan Bicol
    • 1
  • Yang Yang Lee
    • 1
  • Krishnakumar Madhavan
    • 1
  1. 1.Hepato-Pancreato-Biliary Division, Department of SurgeryNational University Hospital SingaporeSingaporeSingapore

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